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Boiler Water System Evaluation Form



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Boiler Number Make of Boiler  Water tube or Fire Tube 

Horse Power or pounds of Steam/Hour


Hours Operated/Day


Fuel Type used  Stoker or Burner Type Used  Main Fireside Problem 

Days of operation/week:

Steam Pressure:_____psi
Fire Box Temp:____ Degrees F Degrees C

Average Daily Fuel Consumption: Summer____ Winter____

Can Stack Damper Be Closed? Yes No

How is soot and fire scale removed?

Frequency of Removal:__________________________


Oil storage tank capacity:_________________________US gal Liters

Number of tanks:_____________

Condition of oil system:

Oil preheat temperature:_______________________ Degrees F Degrees C

Source of makeup water for boiler: City Well River Other (Specify)___________________

Is softened water used for boiler make-up? No Yes - type: Zeolite Demineralized Cold lime-soda Hot lime-soda Other

Boiler water treatment is added by this method (check all that apply) Directly to the boiler Injector Bypass feeder From makeup tank From return condensate tank Chemical Pump Other (specify)

Boiler blowdown schedule: ______ A.M. ______ P.M.

How often is boiler washed?_______________________________________

Heater type: (check all that apply) Open Closed Vented Dearating None

Length of feed line from point treatment is added to the boiler:_____________ feet meters

Condition of feed line:______________________________

Are any of these problems present in the boiler-water? Foam Prime Surge

Summary of boiler inspectors report:

Present condition of water side of boiler: (check all that apply) Scaled Corroded Pitted

Other (describe)

State all purposes for which steam is used. Please be specific. For instance, "processing" would be too generic as a description.

How will the sample of return condensate be taken?

How and where will any of the Alken Treatment-J series be introduced?

Present condition of steam lines:

Where is steam lost?_______________________________________

Treatments currently in use (product names and dosages):

Does engineer have boiler water testing equipment? No Yes - Manufacturers, models, & tests covered):

This survey was conducted for the following reasons: Proposal Letter Lab records Other

Incoming (Make-up) Untreated Water

 Analysis  Survey Results  Variation  Analysis  Survey Results  Variation
 Source      NaCl    
 "P" Alkalinity      TDS    
 "M" Alkalinity      Fe    
 Calcium Hardness      SiO2    
 Total Hardness      pH    


Boiler System (Feedwater) 

 Steam Characteristics

  Analysis Survey Results  Variation  Observation  Survey Results  Variation
 "P" Alkalinity      psig    
 "M" Alkalinity      Temp: Steam    
 Total (Acid) Hardness       Water    
 NaCl      Oxygen: Rated    
TDS      Actual    
 % Make-up      Load: (lb/day)  Summer  Winter


Condensate Characteristics

 Analysis  Survey Results  Variation
 Iron (total or insoluble)    
 % Return    


Boiler Water Controls

 Analysis  Survey Results  Recommended Levels
 "P" Alkalinity    
 "M" Alkalinity    
 "OH" Alkalinity    
 PO4 or Chelate Residual    
 Other (Fe, Si, Oil, etc.)    

Testing Frequency (check ONE) shift daily weekly monthly none

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