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:
CO
2
_____________ %
O
2
______________ %
CO ____________ ppm
Flue temperature _________ Return water temperature (measure simultaneously with flue temp.) _______________
Installers: send this completed sheet - Fax to 604 877 0295 - or - scan and Email to [email protected], and earn
an extra year’s Parts Warranty coverage (User to submit corresponding Installation Record from User Guide).
Commissioning has been completed as listed on this report
- Installer Signature _____________________________
Summary of Contents for SL 28-160
Page 69: ...SERVICE RECORD DATE LICENSED CONTRACTOR DESCRIPTION OF WORK DONE...
Page 70: ...NOTES...
Page 71: ...NOTES...
