One sheet per controller, filled in at setup. Keep a copy with the controller and one in the site file.
¶ Site and controller
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| Site |
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| System (tower, boiler, loop — name or number) |
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| Controller location |
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| Firmware version — Settings → System Info |
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| Main board / port board revisions — Settings → System Info |
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| Profile — Boiler or Custom |
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| Commissioned by |
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| Date |
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¶ Power and network
| Check |
Result |
✓ |
| 24 V supply measured at the controller |
______ V |
☐ |
| Power light solid green |
|
☐ |
| Site WiFi network — or offline |
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☐ |
| Added to an Inteliverse account — account name |
|
☐ |
| WiFi light solid green (or off, if offline) |
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☐ |
| Clock and time zone correct — Settings → Date & Time → Time Info |
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☐ |
| Setting |
Value |
| Baud / parity / stop bits |
______ / ______ / ______ |
| Bus Power |
On ☐ Off ☐ |
| Terminator on at the controller (DIP switch) |
Yes ☐ No ☐ |
| Terminator fitted at the last device |
Yes ☐ No ☐ |
One row per device. For Modbus give the address; for IO-Link the port and pin; for wireless the name shown on the controller.
| Device (make and model) |
Connection |
Address / port |
Label or name |
Serial number |
Reading checked against |
✓ |
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☐ |
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☐ |
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☐ |
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☐ |
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☐ |
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☐ |
Outputs and what each one drives go on the Output Assignment Sheet.
| Mode name |
Type |
Input |
Output |
Setpoint / differential, or timing |
Sampling |
Interlocks |
Enabled ✓ |
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☐ |
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☐ |
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☐ |
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☐ |
| Device and reading |
Low-low |
Low |
High |
High-high |
Deadband |
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With the process in a safe state:
| Test |
Result |
✓ |
Each output run by hand (On  ) and seen to run at the equipment |
|
☐ |
| Each output returned to Auto |
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☐ |
| Each interlock tripped and seen to stop its mode (flow switch closed, tank low…) |
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☐ |
| Each probe calibrated — see the Calibration Log |
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☐ |
| Health light breathing green; no unexpected alarms in the Alarms list |
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☐ |
Alarms left active at handover, and why:
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Name |
Signature |
Date |
| Commissioned by |
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| Accepted by (site) |
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