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Boiler Inspection Checklist Template

This boiler inspection checklist is used for inspecting oil or gas-fired boilers before issuance of certification. Converted using Lumiform, select Safe-At Risk-N/A when inspecting the internal, external, and operation of a boiler.
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Boiler Inspection Checklist Template

Boiler Inspection

Internal Inspection

Combustion Chamber

Brick Work


Fire Water Tubes

Burner Nozzle

Steam Drum

Stack Flue

Blow off Valve

External Inspection


Identify Programmer

Safety Relief Valve

Low Water Fuel Cutouts

Water Column

Pressure Gage

Review Record Logs (weekly, monthly)

Condensing Neutralizer Installed

Hydrostatic Test

Backflow Preventer

Date of last Combustion Tuning

Date of last waterside inspection

Date of last 150% Strength Hydro


Gas Boilers:

• Start in low Fire

• Loss of Combustion Air

• Low Gas Pressure

• High Gas Pressure

Fuel Oil Boilers:

• Start in Low Fire

• Loss of Combustion Air

• Loss of Atomizing Air

• Low Oil Pressure

• Burner Draw Switch (if applicable)

• Proximity Switch (if applicable)

All Boilers:

• Flame Sensor

• LWCO (left Right)

• Feed Pump Recirculating Pump

• Normal Trip

• Flame Pattern Inspection

• Water Treatment

• High Trip

• Emergency Stop

• Combustion Tuning

• Combustion (Air Fuel) Control System

• Test Relief Valve under Pressure

Boiler Efficiency

Boiler is:

Oxygen %

CO ppm


SO2 ppm

NO ppm

Stack Temp.

Safety/Relief Valve:








(check name not set)



Inspector: Name and Signature

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