Start-Up Report / Warranty Registration
Please fill out the following questions as completely and accurate as possible. Please mail
to Champion Pump Company, Inc. – P. O. Box 528 – Ashland, OH 44805.
REPORTS THAT ARE NOT RETURNED CAN DELAY OR VOID WARRANTY.
Pump Owner’s
Name:__________________________________________________________________
Address:________________________________________________________________
Location of installation:____________________________________________________
Phone:__________________________________________________________________
Purchased from:__________________________________________________________
Pump Model_______________Serial #__________________Date Code:_____________
Date Installed:____________________________________________________________
Does impeller turn freely by hand? YES____________NO___________________
Condition of cord jacket? Good________Fair________________Poor_____________
Was equipment stored?___________How long?_________________________________
Liquid being pumped______________________________________________________
Debris in bottom of station?________Was debris removed in your presence?__________
Discharge pipe size?___________ Length of pipe?_________Static lift?_____________
Does station appear to operate at the proper rate?_______Pump down time?___________
Voltage At Wiring Terminal L1-L2__________L2-L3__________L1-L3__________
Run Amps L1_______________L2_______________L3_______________
3 Phase Models – Check Proper Rotation? Yes / NO
Difficulties during start up:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
I certify this report to be accurate (start up person)____________________________________
Employed by___________________________________ Date: _________________________
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