Cleanroom Environmental System Commissioning Form

Project Information

Project Name:
Location:
Date:
Commissioned By:
Client Representative:

System Description

System Name:
Overview:

Commissioning Checklist

Item Status Comments
HEPA/ULPA Filters Installed
Air Change Rate Verified
Room Pressure Control Active
Temperature & Humidity Stable
Alarms & Indicators Functional
System Balancing Complete

Test Results

Parameter Specified Measured Pass/Fail
Room Temperature (°C)
Room Humidity (%)
Particle Count
Room Pressure (Pa)

Observations & Notes

Sign-Off

Commissioning Engineer Name:
Signature:
Date:
Client Representative Name:
Signature:
Date: