INSTALLATION & COMMISSIONING REPORT
Boiler Details:
Model Number
_____________________
Serial Number
______________________________________________
Date of Installation
______________
Address of installation
__________________________________________
_____________________________________________________________________________________________
User contact information
_______________________________________________________________________
Installer Information
Company ___________________________________________________________________
Address ______________________________________________________________________________________
Phone/Fax/E mail ____________________________________________________________________________
__
Fuel
Natural Gas
Propane
Gas Supply Pressure (high fire)
_______ Inches w.c.
Measured Rate of Input (high fire)
____________ Btu/hr
Installation instructions have been followed and completed (Section 1 of Installation and Operating Instructions).
Check-out procedures have been followed and completed (Section 3 of Installation and Operating Instructions).
Leak testing completed
gas piping
venting system
Fan and combustion components
System Cleaned and Flushed (type of cleaner used) ________________________________________________
System Filled (type/concentration of any glycol/chemicals used) _______________________________________
Air purge completed
Relief Valve correctly installed and piped
Relief valve “try lever” test performed
Condensate trap filled
Condensate drain clear and free flowing
Condensate Neutralization? Yes/No
Ignition Safety Shutoff test completed. Flame current reading - High fire _______ µA - Low fire _______ µA
Owner advised and instructed in the safe operation and maintenance of the boiler and system.
Information regarding the unit and installation received and left with owner
Combustion Readings -
recommended, but optional
(required for fuel conversion):
CO
2
_____________ %
O
2
______________ %
CO ____________ ppm
Flue temperature _________ Return water temperature (measure simultaneously with flue temp.) _______________
Refer to website for registration.
Commissioning has been completed as listed on this report
- Installer Signature _____________________________