Equipment Commissioning Form Number/Rev #

EHS-00017-F1 R17
Checklist

Date of
Applicant:      
Commissioning:
Name of Organization:      
Tool Owner:      
/ /
                 

Tool Identification Equipment Description

Tool ID Code:            
Tool Name:            
Supplier:            
Model:            
Equipment Status
New - anticipated arrival date -       /       /      
Relocated (equipment must be decontaminated) - from other location
from within CNSE Facilities
Change to Existing Installation (only complete sections that apply)
Description of Change(s):
     

Code
Responsible Parties Full Name Initials Phone #
(R)
Installation Coordinator
IC                  
Tool Owner
TO                  
Tool Engineer/
TE/EE                  
Equipment Engineer
CNSE
Environmental, EHS                  
Health & Safety
CNSE Facilities Tool
-                  
Hook-up Manager

This checklist is for use in approving the completed installation of tools using Hazardous
Production Materials (HPM) and equipment for commissioning to be used in the CNSE
Facilities. The checklist is divided into two (2) parts. Part 1 covers the electrical, mechanical,
non-HPM chemicals and facilities release. Part 2 covers the release of all Hazardous
Production Materials and Physical Hazards for tool/equipment operation. This checklist
must be completed prior to releasing the tool/equipment to the tool owner for process
transition and operational use.

Printed copies are considered uncontrolled. Verify revision prior to use.

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 Equipment Commissioning Checklist EHS-00017-F1 R17

PART 1 EQUIPMENT COMMISSIONING CHECKLIST

Electrical & Mechanical Activation, Non-HPM Chemicals and Facilities Release
In some cases electrical energy must be supplied to execute portions of the Part 1 Checklist. Necessary
electrical power circuits may be released from LOTO, following approval from CNSE Facilities EHS, in
order to check proper operation of these subsystems. The circuits must then be returned to a LOTO state
until Part 1 is approved.

When the Part 1 Checklist is fully and successfully completed, all electrical power, vacuum, non-HPM
chemical and water facilities may be activated. All other systems associated with the tool/equipment (i.e.
physical, HPM chemical, radiation, or other hazards) must remain completely locked out until installation
is complete and the Part 2 Checklist is approved.

A. Electrical Matrix
NA
List all sources of electricity to the tool/equipment (IC)
Name of Panel / Feeder Voltage (V) Breaker
Current Lockable
List Tested & Phase Size
(A) Disconnect?
Voltage Verified? (A)
                                   
                                   
                                   
                                   
                                   

N B. Electrical Safety Requirements IC TE/EE EHS

A
1. Has ground continuity been verified? (Ground/bond straps installed & X X
verified where applicable)
2. Has the facility power network from the distribution or branch panel to the X X
tool main disconnect been verified for correct connections and labeling?
3. Are there lockable main power disconnects readily accessible, properly
X X X
labeled, and capable of disconnecting all electrical power sources to the
machine?
4. Is electrical wiring/ equipment protected from probable liquid leak sources? X X

5. Is a
X X
Ground Fault Circuit Interrupt (GFCI) system installed & operating per design,
where applicable? N/A
6. If installed in hazardous classified locations or exposed to flammable
vapors, are all electrical components rated for hazardous locations in accordance X X
with ICC Electrical Code class, group & division per design?
7. Is the tool connected to an Uninterruptible Power Supply (UPS unit & tool
X X
labeled accordingly)?
N/A
8. Are all support systems (i.e. vacuum pumps, chillers, etc.) fed from the tool X X X
or sub-panel properly connected and labeled?
9. Are the following items labeled correctly and clearly? (labeling requirements
in parentheses)
a. Main power disconnect (On/Off, tool ID(s) that it supplies, voltage, X X X
phase, current, supply circuit #, location / ID of supply sub-panel)
b. Supply electrical sub-panel (tool identification that it supplies) X X X

c.All tool disconnects (On/Off, tool ID(s) that it supplies, voltage, phase, X X X
current, supply circuit #, location / ID of supply sub-panel, type of power (e.g.

Printed copies are considered uncontrolled. Verify revision prior to use.

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 Equipment Commissioning Checklist EHS-00017-F1 R17

N B. Electrical Safety Requirements IC TE/EE EHS

A
Normal, UPS)).
d. Convenience outlets (circuit breaker #, panel #). X X X
N/A
e. Are tool status indictors (i.e. light trees) labeled appropriately? X X

10. Are all unused openings in electrical panels or enclosures properly closed? X X X

NA Cord & Plug

C. Lockout/Tagout and Hazardous Energy Control IC TE/EE EHS
NA
1. Have Lockout / Tagout (LOTO) procedures been developed specific to this X X
equipment and submitted to EHS?
2. Are means provided for isolation (LOTO) of all hazardous energy sources
(mechanical, pneumatic, hydraulic, and chemical, radiation, etc.) & are all X X
isolation points identified and documented?
3. Prior to Part 1 sign-off, are all hazardous energies completely locked and X
tagged out?
4. Has the activation of any Part 1 (non-HPM) utility (e.g. electrical) been
verified to ensure that installation personnel will NOT be exposed to hazardous X X
conditions during remaining installation activities? If not, please describe. ↙
N/A
Notes and Comments:      

D. Access and Clearance Requirements IC TE/EE EHS

1. Is the minimum work space clearance in front of electrical equipment that is
likely to require examination, adjustment, servicing, or maintenance while X X X
energized compliant with NEC. (36" for < 150 V or 42-48" for 150-600 V,
depending on NEC conditions).
2. Is the width of the working space in front of electrical equipment the width of X X X
the equipment or 30 inches, whichever is greater (NEC)?
3. Is there a minimum of 80" clear headroom in electrical workspace per NEC? X X X

4. Is there a 36" horizontal servicing clearance for HPM workstations (per X X X

NYSFC 1805.2.2.3)?
5. Do all exterior doors and access panels warn of the hazards located behind X X
them?

N E. Lasers N/A TE/EE EHS

A
List Type & Quantity: Class 1       Class 1M       Class 2       Class 2M       X X
Class 3R       Class 3B       Class 4      
1. Is a label visibly present on the outside of the tool, certifying compliance with X
FDA -CDRH requirements (21 CFR 1010.2)?
2. Is equipment containing lasers labeled per ANSI Z136.1 & per 21 CFR 1010 X
& 21 CFR 1040.10?
3. Are all laser interlocks functional and is the Activation Warning System X X
operational as required?
4. Is there a protective housing around the laser? X X
Printed copies are considered uncontrolled. Verify revision prior to use.

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 Equipment Commissioning Checklist EHS-00017-F1 R17

5. Are all removable service access panels either interlocked or require a tool X X
for removal?
6. Do all viewing portals attenuate to class 1 or less? X X X

7. Is there open beam exposure potential to class 3B or 4 Lasers? If so, X X X

complete the form: EHS-00048-F1, Requirements for a Class 3B or 4 Laser.
8. Have all Lasers been added to the CNSE Facilities Laser Inventory (EHS- X X X
00016-F5) and reviewed by the CNSE Radiation Safety Officer?

NA F. Radiation Requirements N/A TE/EE EHS

1. If hazardous UV light sources are present, are the sources enclosed, X X X
interlocked and properly labeled?
2. Are sources of strong magnetic fields (>5 gauss) properly labeled with X X X
pacemaker hazard, field strength and hazard distance?
3. Have all RF & microwave sources been identified and properly labeled? X X X

4. Have all sources of non-ionizing radiation been reviewed by CNSE X X X

Radiation Safety Officer?
5. If X-ray sources are present, are the sources enclosed, interlocked and X X X
properly labeled?
6. Is the power supply to all radiation sources (ionizing and non-ionizing)
X
locked / tagged out and is all shielding in place? (NOTE: Radiation sources will not
be energized prior to Part 2 sign-off.
7. Have all sources of ionizing radiation been reviewed by CNSE EHS and the X X X
CNSE Radiation Safety Officer?
8. Have all sources of ionizing radiation been added to the CNSE EHS X X
Radiation Device Inventory (EHS-00016-F2)?
9. Are all sources of ionizing radiation registered with the NY State Department X X
of Health?
Radiation Sources (TE)
Check all that apply Frequency and/or Wavelength Maximum Power Properly Labeled?
RF / Microwave             Yes No
Ultraviolet             Yes No
Infrared             Yes No
X-Ray             Yes No

G. List All Utilities (Non-HPM Gas &/or Liquid, Chiller, Process Vacuum, CDA, Water, Facility Lines,
NA
or Natural Gas Lines, etc.) Needed For Part 1 Sign-off
Utility Needed Labeled? Leak Checked? Comments:
      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
IC TE/EE EHS
1. Are all non-HPM gas &/or liquid, chiller, PVAC, CDA, water, facility lines or natural X X X
gas lines, etc. clearly labeled (contents & direction of flow) at every change of
direction, before & after every structural penetration, and at regular intervals
Printed copies are considered uncontrolled. Verify revision prior to use.

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 Equipment Commissioning Checklist EHS-00017-F1 R17

according to CNSE Facilities guidelines?

2. Have all non-HPM gas &/or liquid, chiller, PVAC, CDA, water, facility lines or natural
gas lines, etc., supplying non-HPM materials, been pressure/leak checked and X X X
documented (if applicable)?

Printed copies are considered uncontrolled. Verify revision prior to use.

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 Equipment Commissioning Checklist EHS-00017-F1 R17

H. Onboard Non-Process Chemical Inventory

NA To be filled out by Tool Engineer. List all chemicals such as refrigerants, coolants, additives,
pump lubricants, etc. used in the tool or its peripherals.
Loop / Tank (check
Manual MSDS Received Approval
Chemicals Used & Concentration box)
Fill? Submitted from EHS?
(full chemical name) Closed Volume
Yes / No Tank (mm/dd/yyyy) Yes / No
Loop (gal)
                 
                 
                 
                 
                 

NA I. Guarding IC TE/EE EHS

1. Are all electrical, thermal, and mechanical hazards (i.e. pinch-points, moving X X
parts, etc.) properly guarded and labeled?
2. Are all robotics envelopes adequately defined and guarded? X X
N/A

N J. Personal Protective Equipment IC TE/EE EHS

A
1. Is the proper PPE available for all operations & maintenance tasks X X
associated with this equipment? Please list:      
2. Is proper PPE storage available? X X

N K. Tool Identification IC TE/EE EHS

A
1. Is the proper tool identification with primary and secondary tool owners listed X X
and posted?
2. Has the tool matrix been updated and submitted to CNSE EHS? X X

3. If the tool installation alters the layout of the cleanroom space, has a new X X
evacuation map been submitted to CNSE Facilities EHS? N/A

NA L. Seismic Restraints IC TE/EE EHS

1. Seismic bracing and anchoring designed utilizing the following data:
1) Seismic Use Group: II; 2) Seismic Design Category: D; 3) Spectral Response
Coefficients: a. Sds = 43.85 (%g); b. Sdl = 21.14 (%g); 4) Site Class: E; 5) Basic
Seismic Force Resisting System: Dual System Special Reinforced Moment Frame X X X
With Special Reinforce Concrete Shear Walls; 6) Design Base Shear: V = 2560
KIPS; Analysis Procedure: Equivalent Lateral Force Procedure.

NA M. HPM Delivery System (Liquids and Gases) IC TE/EE EHS

1. How many output delivery lines/sticks exit from supply unit and/or components?       X X
(write in number)
2. Have Chemical/Gas Services applied process control locks to each of the output X X
lines/sticks?       (write in number of locks applied)

Printed copies are considered uncontrolled. Verify revision prior to use.

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3. Have Tool Installation applied process control locks to each of the output lines/sticks? X X
      (write in number of locks applied)
4. Have EHS applied process control locks to each of the output lines/sticks?       (write in X
number of locks applied)
NA N. TGMS Controls & Matrix IC TE/EE EHS
1. Have TGMS/AAC interlock signals been provided by the tool engineer to the TGMS X X X
contractor?
2. Has the approved TGMS matrix been submitted and been signed by all of the appropriate X X X
parties?
X X X
3. Is a copy of the approved signed TGMS matrix included in this greenbook?

Part 1 Punch List

List all deficiencies that do not affect the safety of the installation. A Punch List item may not compromise safety.
Punch List items must be completed prior to Part 2 sign-off.

Issue Responsibility Completion Date

1.                  
2.                  
3.                  
4.                  
5.                  
6.                  
7.                  
8.                  
9.                  
10.                  

Notes and Comments

     

Part 1 Interim Sign-offs N/A Signature Print Name Date

1a) EHS: Electrical Power: Debug                  
1b) EHS: Non-HPMs                  
2a) System Owner: Process Vacuum                  
2b) System Owner: Compressed Dry Air                  
3a) System Owner: Ultra Pure Water                  
3b) System Owner: Process Cooling Water                  
4a) System Owner: Bulk Gases/Non-HPMs                  
5a) System Owner: Bldg. Electrical Power                  

Printed copies are considered uncontrolled. Verify revision prior to use.

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 Equipment Commissioning Checklist EHS-00017-F1 R17

Printed copies are considered uncontrolled. Verify revision prior to use.

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 Equipment Commissioning Checklist EHS-00017-F1 R17

Part 2 Equipment Commissioning Checklist

Release of all Hazardous Production Materials & Physical Hazards for Engineering Use

A. General N/A TE/EE EHS

1. Has the ERT Coordinator been informed of the equipment installation and X X X
become familiar with its emergency shutdown procedures?
2. Final Approval / Sign Off of the Part 2 Inspection by EHS is contingent upon X X X
the completion of the following two steps:
a. Procedures concerning new or unusual hazardous processes or
materials have been documented and training provided to an ERT Leader or
Alternate Leader on all four shifts
b. An ERT Leader or Alternate Leader from each shift must acknowledge
(through their signature below) that they have been provided with a physical
tour of the newly installed equipment. This tour must include an overview of
emergency features (EMO’s, Gas Detector Locations, Interlocks, Smoke
Detection, Fire Suppression Systems…)
Day 1 ERT Leader:
Day 2 ERT Leader:
Night 1 ERT Leader:
Night 2 ERT Leader:

3. Are there any additional hazards, equipment or conditions that the ERT need X X X
to be trained on?
a. If applicable has a SOP been developed to cover this training?
b. If yes has such training taken place for each shift?
D1 Yes No N1 Yes No D2 Yes No N2 Yes No
4. Are there confined space hazards associated with the tool's operation or X X X
maintenance? Has a process been developed for entering such a confined space?
5. Has the S2 noise survey verified that the equipment operates at <80 dBA? If X X
not, has a field survey been completed to determine impact to the area?
6. Is the work area adequately illuminated? X

7. Are there any specially negotiated working conditions? If so, please describe.
X X


Notes and Comments:      

NA B. Exhaust Ventilation (IC)

Type:
Location scrubbed, Flow Monitoring Devices Set Points
List all exhaust outlets heat Type and Location Labeled
solvent, etc.
                  Yes No
                  Yes No
                  Yes No
                  Yes No
                  Yes No
Printed copies are considered uncontrolled. Verify revision prior to use.

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Printed copies are considered uncontrolled. Verify revision prior to use.

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 Equipment Commissioning Checklist EHS-00017-F1 R17

NA C. Exhaust Ventilation Requirements IC TE/EE EHS

1. Heat exhaust only? X X X

2. Are all exhaust ducts labeled with contents and direction of flow at every
change of direction, before & after every structural penetration and at regular X X X
intervals according to CNSE Facilities labeling guidelines?
3. Has a ventilation test and balance been completed and submitted to EHS and X X X
are all dampers marked and locked?
4. Do all ventilation systems that handle HPMs have continuous monitoring
X X
devices (i.e. photohelic, magnehelic, etc.) installed?
N/A
a. Are all monitoring devices in the plenum functional, secured, properly X X X
set & labeled with set points?
b. Are all monitoring devices at the tool functional, secured, properly set & X X
labeled with set points?
5. Are blast gates on all ventilation systems locked? X X X

6. Has a loss of exhaust test been performed to verify that the tool is placed in a
X
safe condition upon loss of exhaust ventilation flow?
N/A
7. Have Industrial Hygiene Ventilation Assessments (capture velocity) been X
completed for all areas where hazardous chemicals may be exposed to the open
environment (i.e. wet stations, lab hoods, wet chemical dispense cabinets, etc.)?
N/A
8. Are local exhaust systems provided for maintenance activities? If so, please X X
describe.       N/A
Notes and Comments:      

N D. Vacuum Pumps IC TE/EE EHS

A
1. Are all inputs and outputs labeled with direction of flow and are all lines X X X
adequately secured?
2. Has the vacuum pump rotation been verified? X X

3. Are all vacuum Pump EMOs and interlocks functional (e.g. nitrogen purge, X
back-pressure, temperature, cooling water flow) and documented?
4. Are all vacuum pumps that convey toxic gases contained within an exhausted X
enclosure? N/A
5. Are all Nitrogen and water flow indication devices functional? X X

6. Where applicable, are the shaft seal nitrogen purges operational? X X

N/A
7. Is exhaust piping routed to prevent pooling of liquids? (no visible low spots or X X
sagging).
8. Have appropriate measures been taken to prevent back streaming into the X X
house nitrogen system?
X
9. For oil sealed pumps, list oil type:       N/A
X
a. Is the pump oil compatible with the process materials?

Printed copies are considered uncontrolled. Verify revision prior to use.

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 Equipment Commissioning Checklist EHS-00017-F1 R17

N D. Vacuum Pumps IC TE/EE EHS

A
X
b. Has an oil drip pan been installed under the entire pump package?
X
c. Is an oil demister or separator installed if required?
d. Are the pump-case purge and or pump ballast purge interlocked? (oil X
sealed pumps)

E. Local Dispense and Bulk Chemical Inventory

NA
To be filled out by Tool Engineer. List all aqueous or solvent chemicals supplied to the tool.

Manual Bath or Tank (check one) MSDS

Chemicals Used & Concentration Date MSDS
Pour? Volume submitted?
(full chemical name) Bath Tank Approved
Yes / No (gal) Yes / No
                 
                 
                 
                 
                 
                 

N/A Chemical Distribution Matrix (to be completed by Tool Engineer)

Chemical Dispense Unit
Chemical Dispensed Comments
Name (MDU      )
                 
                 
                 
                 
                 
                 

N F. Local Dispense Chemical Delivery Systems Requirements IC TE/EE EHS

A
1. Are all chemical supply lines and containment piping clearly labeled (contents
& direction of flow) at every change of direction, before & after every structural X X X
penetration, and at regular intervals according to CNSE Facilities labeling
guidelines?
2. Are all appropriate locations (tool, all support equipment, and chemical X X X
enclosures) labeled with point-of-use chemical labels and/or HAZCOM labels?
3. Have all chemical (HPM or otherwise) supply lines been pressure and leak
X X
tested and documentation of such submitted to EHS? Are they double contained
where required?
4. Are all valves and fittings for HPM liquid delivery systems contained within a X X X
ventilated enclosure? N/A
5. Are leak detection systems adequately installed for the equipment and in all X X X
chemical valve boxes?
a.Have all liquid leak detection systems been tested and verified to be X X X
operational and documented as such?
b.Have all exhaust pressure detectors been tested and verified to be operational X X X
and documented as such?
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N F. Local Dispense Chemical Delivery Systems Requirements IC TE/EE EHS

A
c.Have all heat detectors, if applicable, been tested and verified to be X X X
operational and documented as such?
6. Are all pressurized chemical containers equipped with the following:
N/A
a.If pressurized to >15 psig, are they ASME rated and provided with over- X X
pressure protection?
b.If non-rated, are containers equipped with pressure relief devices set to a X X
maximum of 15 psig?
c.Vented to the system exhaust? X X

d.Equipped with functional liquid level detection and overfill protection? X X

e.Bonding / grounding & provided with an inert pressurizing agent (for flammable X X
chemical containers)?
7. Are all access areas to pressurized lines shielded / interlocked to prevent X X X
potential exposure to chemistries?
8. Are safety showers / eye wash stations located within 10 seconds travel or 50
feet of chemical use or closer depending on the degree of hazard associated with X X
the chemical(s) used? (ANSI Z358.1-1990)
N/A

N G. Bulk Chemical Delivery Systems Requirements IC TE/EE EHS

A
1. Are all chemical supply lines and containment piping clearly labeled (contents
& direction of flow) at every change of direction, before & after every structural X X
penetration, and at regular intervals according to CNSE Facilities labeling
guidelines?
2. Are all appropriate locations (tools, all support equipment, and chemical X X X
enclosures) labeled with point-of-use chemical labels and / or HAZCOM labels?
3. Are all bulk chemical delivery lines and containment piping attached to the
correct point of use and terminated at the tool? (no fittings within the double X X X
contained piping)
4. Are all valves and fittings for HPM liquid delivery systems contained within a X X X
ventilated enclosure? N/A
5. Is liquid leak detection properly installed in all chemical valve boxes? X X X

a. Have all leak detection systems been tested and verified to be X

operational and documented as such?
6. Have all HPM delivery lines been verified to have secondary containment? X X
N/A
7. Have all HPM delivery lines been leak tested or pressure tested, documented, X X
reviewed and accepted? N/A
8. Have all chemical valve boxes been leak tested, documented, reviewed and X
accepted?
9. Does the chemical valve box supply to the tool close upon EMO activation X
from the tool?
10. Are all emergency HPM shutoff valves clearly visible and indicated by means
X X X
of a sign? (NYSFC 2703.2.2.1.4)
N/A
11. Are all flammable and combustible materials sealed from electrical equipment X X
or ignition sources?

Printed copies are considered uncontrolled. Verify revision prior to use.

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N G. Bulk Chemical Delivery Systems Requirements IC TE/EE EHS

A
12. For new bulk chemical installations, has the following information been
submitted to the EHS department to calculate HPM allowances for each control
area? X X X
Chemical type/name:       # of cylinders:      
Size:       pounds/container OR       gallons/container
13. Have PLC communications systems been properly:
a. wired and connected to the tool. X X X
b. programmed & verified to send correct signals to the correct valves per
design?

N H. Gas Delivery Systems Requirements IC TE/EE EHS

A
1. Have all lines been traced to origin and verified? X

2. Are double contained lines (coaxial tubing) in place as required? X X

N/A
3. Have coaxial tubing been pressurized to 100 psig, with warning and alarm X X
points set?
4. Are all gas lines clearly labeled (contents & direction of flow) at every change
in direction, before & after every structural penetration, and at regular intervals X X
according to CNSE Facilities labeling guidelines?
5. Are all gas-cabinets/VMBs properly labeled with "tool destination labels"? X X X

6. Are all enclosures (e.g. gas cabinets, VMBs, GIBs, tool chambers, tool gas X X X
boxes) properly labeled with approved HAZCOM labels?
7. Are all leak points for HPMs exhausted and / or fitted with gas detection per
X X
the design?
N/A
8. Have all gas delivery systems internal to the tool been leak checked and X X
documented?
9. Have all gas delivery systems external to the tool been leak checked and X X
documented?
10. Has leak detection checklist(s) been completed and submitted to EHS? X X X

11. Are all valves and fittings on HPM gas systems contained within a ventilated X X X
enclosure per design? N/A
12. Are all gas cabinets vent lines located after the blast gate, on a lateral or at X X
least five duct diameters downstream from a TGMS sensor?
13. Have PLC communications systems been properly:
a.wired and connected to the tool. X X
b.programmed & verified to send correct signals to the correct valves per
design?
14. For new gas cabinet installation, has the following information been submitted
to the EHS department to calculate HPM allowances for each control area? X X X
Gas cylinder type:       # of cylinders:      
Size:       pounds/cylinder OR       cubic feet/cylinder

Printed copies are considered uncontrolled. Verify revision prior to use.

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 Equipment Commissioning Checklist EHS-00017-F1 R17

N I. Detection/Monitoring Requirements IC TE/EE EHS

A
1. Has continuous detection been installed at appropriate monitoring points per X X X
design? (NYSFC 1803.13.1)
2. Has each monitoring point been checked to verify that upon activation, an
automatic, fail-safe source shutdown occurs and a visible / audible area alarm is X X X
initiated and has documentation of such been submitted to EHS? (i.e. TGMS Matrix
sign-off)
3. Have all detector points been installed so that they are accessible and visible? X X X

4. Are all detector points adequately labeled and easily read? X X X

5. Are the gas detectors positioned before the blast gate? X X X

6. Has the gas cabinet vent line been placed at least 5 duct diameters upstream X X X
from the gas detectors?
7. Have newly added detection points been added to TGMS site summary and X X X
posted at the TGMS touch screens?
8. Is a map of the new detector locations available and posted at the AAC? X X X

9. Has a TGMS matrix pre-test been scheduled and performed? X X X

10. Is the completed and signed TGMS matrix pre-test attached? X X X

11. Is the completed and signed final TGMS matrix attached and has a copy been X X X
submitted to EHS?

NA Detection/Monitoring Matrix (to be completed by IC and TE/EE)

Detection WARNING ALARM Functional Test
Gas Sample Point Locations
Points Set Point Set Point Date
                                   
                                   
                                   
                                   
                                   

N J. Drain Matrix
A
Material of Leak Checked Piping Labeled Properly
Drain System (TE)
Construction (TE) (if required) (IC) (IC)
                       
                       
                       
                       
                       

NA K. Chemical Disposal Requirements IC TE/EE EHS

1. Is all drain piping clearly labeled (contents & direction of flow) at every change
X X X
of direction, before & after every structural penetration and at regular intervals
according to CNSE Facilities labeling guidelines?
2. Is all workstation drainage piping connected to a compatible system so as to
avoid chemical reactions generating heat, gases, or dangerous by-products per X
design?
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 Equipment Commissioning Checklist EHS-00017-F1 R17

N J. Drain Matrix
A
Material of Leak Checked Piping Labeled Properly
Drain System (TE)
Construction (TE) (if required) (IC) (IC)
3. Are HPM drain lines double contained where required? X X X

4. Are HPM drain lines leak checked and documented as such? X X X

5. Has all drain waste and vent piping been tested for proper performance via X X
operation of the process equipment?
6. Are appropriate waste receptacles/containers/units available in the work area X X
and properly labeled?
7. Are segregated satellite collection locations present and labeled as needed? X X
(e.g. arsenic or lead waste)
8. Is the workstation provided with an approved means of containing or directing
spills to a drainage system per design (i.e. slope or other approved means of spill X X X
containment)? (NYSFC 1805.2.2.2)

NA L. Post-Process Exhaust Treatment Systems (TE/EE Check all that apply)

Passive Dilution / Reaction Chamber Dynamic Neutralization Chamber (DNC)
Thermal Decomposition Unit (TDU) Wet Chemical Reactors
Dry Chemical Reactors Other:

Post-Process Exhaust Treatment Systems IC TE/EE EHS

1. Is the post-process exhaust treatment system operational, and are all X X X
interlocks functioning?
2. Does the process gas flow shut down in the event of exhaust treatment X X
system failure?
3. Upon activation of a trouble alarm, does the system place the tool into a safe X X
condition and send an alert via the TGMS or BMS?
4. Does the exhaust treatment system configuration allow access for inspection X
and cleaning?
5. Is a fire sprinkler (wax coated, plastic bag, quick response) installed
downstream of the reaction chamber, at the transition to the main exhaust lateral per X X
design? (Is water drainage adequate?)
6. Is the post-process exhaust treatment system labeled with HAZCOM labels or X X
similar identifying the process gas and corresponding by-products?
7. Have post-process exhaust emission calculations been submitted and
approved by EHS to ensure adequate exhaust treatment and posted on the X X
treatment unit?

NA M. Fire Detection (TE/EE check all that apply)

High sensitivity detection (Optical Air Sampling Smoke Detection, e.g. VESDA, HSSD)
Locations:      
Smoke Detection:      
UV / IR detection:      
Other:      

N N. Fire Protection Requirements IC TE/ EE EHS

A
1. Has annunciation been verified for all equipment-specific fire detection X X X
Printed copies are considered uncontrolled. Verify revision prior to use.

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 Equipment Commissioning Checklist EHS-00017-F1 R17

N N. Fire Protection Requirements IC TE/ EE EHS

A
devices?
2. Has equipment-specific fire alarm annunciation been verified? X X X

3. Are lab hoods that use flammable / combustible liquids serviced internally by a X X X
fire sprinkler head and added to the CNSE laboratory hood inventory?
4. For Wet Stations (all wet chemical processes), are sprinklers installed on the X X X
bay ceiling in front and behind the tool, providing coverage to all areas of the tool?
5. Do all workstations of combustible construction have a sprinkler head installed
in the exhaust duct / plenum within 2 feet of the point of the duct connection or the X X X
connection to the plenum? (NYSFC 1803.10.1.1)
6. Are heat detectors/sprinklers installed in all combustible ducts & non-
X X X
combustible ducts conveying vapors or gases in the flammable range (>10% LEL)
that are ≥ 10" in diameter. (NYSFC 1803.10.1.1)
7. Has all fire suppression agent (i.e. sprinkler, CO2, etc.) delivery piping leading X X X
into enclosed equipment been pressure tested?
8. Has it been verified that fire sprinkler flow patterns within enclosed equipment X
are unobstructed?
9. Are fire suppression/detection systems installed within enclosed equipment
X
where necessary and have they been tested and verified functional, providing the
required discharge density?
10. Are all sprinklers that service the area occupied by this equipment accessible X X X
for periodic inspections?

N O. Local Fire Suppression/Detection System Documentation IC TE/EE EHS

A
1. Has the System been certified & documentation submitted to EHS? X X X

2. Have the System Manuals been submitted to EHS? X X X

3. Has the Local Fire Suppression/Detection System Summary Sheet been X

updated?

Printed copies are considered uncontrolled. Verify revision prior to use.

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 Equipment Commissioning Checklist EHS-00017-F1 R17

N P. Emergency Machine Off (EMO) IC TE/EE EHS

A
1. Does the EMO turn off all electrical power to the system including the UPS X
(except non-hazardous control voltage and power sources to safety related devices)?
2. Upon resetting of the EMO, does the equipment remain shutdown and require X
a manual re-start?
3. Are EMO buttons located within 10 feet of all operating & scheduled
maintenance locations or where a physical barrier (wall, floor, panel, etc.) separates X X
work locations from the EMO button?

N Q. Interlocks
N/A TE/EE EHS
A Note: This section applies to all interlocks internal to the equipment.
1. Has an interlock matrix (indicating what is activated or shutdown when each
interlock is activated) been provided for each of the following interlocks?
a.Exhaust flow (e.g. photohelic)? X X X

b.Temperature / Fire Detection (e.g. over temp., UV Sensor)? X X X

c.Mechanical (e.g. pinch points)? X X X

d.Robotics and/or Automation (e.g. light curtains, IR Sensors)? X X X

e.Pneumatic / Hydraulic? X X X

f. Electrical (e.g. High Voltage, door panels)? X X X

X X X
g. Other?      
2. Have all interlocks been tested and verified to be operational as indicated on X X X
the interlock matrix and has such documentation been submitted to EHS?
3. Have any changes been made to the tool or operating system that may have X X X
affected the functioning of any interlocks?
a.If so, have all interlocks been re-tested after every such change & verified to X X X
be operational?
4. In case of alarm, does the local gas detection system have interlocks to stop X X X
the gas flow into a gas cabinet?
5. Are other interlocks connections from the tool or process chamber/modules
X X X
available for connection to an area alarm control panel? If yes, are these interlocks
connected to the area alarm control panel?

N R. Radiation Requirements N/A TE/EE EHS

A
1. Have all sources of non-ionizing radiation been surveyed by CNSE Radiation X X X
Safety Officer?
2. Have all sources of ionizing radiation been surveyed by CNSE Radiation X X X
Safety Officer?

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 Equipment Commissioning Checklist EHS-00017-F1 R17

S. HPM Delivery System (Liquids and Gases)

IC TE/EE EHS
NA Process Control Isolation Lock Removal
1. What output delivery lines/sticks are requested to be turned on?       (fill in X X
line information)
2. How many remaining output delivery lines/sticks will remain locked out for X X
process control?       (fill in number and type)
3. Identify number and line/stick label for each Tool Installation lock to be
removed? X X
     
X X
     
X X
      X X
     
4. Identify number and line/stick label for each Chemical/Gas Services process
control lock to be removed? X X
     
X X
     
X X
      X X
     

Notes and Comments

     

Part 2 Interim Sign-offs

This section serves two functions:
1) Allows EHS to provide partial approvals in phases as the tool is prepared for use.
2) Provides System Owners the opportunity to review and approve the parts of the project that they will own.
Phase N/A Signature Print Name Date
1a) EHS: Electrical Power: Laser                  
1b) EHS: Electrical Power: Radiation                  
1c) EHS: HPMs                  
1d) EHS: TGMS                  
2a) System Owner: House Exhaust                  
3a) System Owner: House Drain: AWD                  
3b) System Owner: House Drain: HFD                  
3c) System Owner: House Drain: Solvent                  
3d) System Owner: House Drain: Slurry                  
4a) System Owner: Hydrogen                  

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 Equipment Commissioning Checklist EHS-00017-F1 R17

5a) Gas and/ or Liquid Delivery and/ or

Waste Collection Systems By Air Liquide                  

Part 2 Punchlist
List all deficiencies that do not affect the safety of the installation. A Punchlist item may not compromise safety.
Punchlist items as well as Deficient items must be completed prior to Part 2 approval.
Issue Responsibility Completion Date
1.                  
2.                  
3.                  
4.                  
5.                  
6.                  
7.                  
8.                  
9.                  
10.                 
11.                 
12.                 
13.                 
14.                 
15.                 

Equipment Commissioning Part 2 Approval Signatures

I verify that all Part 1 and Part 2 checklist items (deficient or otherwise) are complete
& I approve this equipment for Part 2 sign-off.
Title Signature Print Name Date
Installation Coordinator (IC)                  
Tool Owner (TO)                  
Tool Engineer / Equipment Engineer
(TE/EE)                  
CNSE Environmental Health & Safety
(EHS)                  
CNSE Facilities Tool Hook-up Manager                  
CNSE Code Compliance Manager                  
CNSE Facilities Director                  
CNSE ERT Coordinator                  

Printed copies are considered uncontrolled. Verify revision prior to use.

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