HM200
30
Guarantee request
9 Guarantee request
We have received the following Kroll-space heater / heating system, which has been installed by the heating contractor listed below.
Type
Serial-No..
Our address (user)
Our heating contractor (installer)
To
be f
ille
d in b
y t
he use
r
Telephone
Telephone
The following person in our firm is responsible for the operation.
and servicing: Mr.
We are interested in taking out a service contract on the
appliance. Please send us further information:
We have been fully instructed in the operation of the appliance or system. We have been given the operating instructions.
Please send us the guarantee certificate
Place
Date
User’s signature and stamp
Burner installed
Oil
Gas
Combined oil / gas
Manufacturer
Type
No.
To
be f
ille
d in b
y sk
ille
d
w
or
k s
ho
p
Tes
t dat
a
Oil burner
Gasburner
Nozzle type and
number
Oil flow
rate
Express-
pressure
pump
Type of
gas
Gas
nozzle
Flow-
pressure
filter-
inlet
Flow pressure
nozzle
mbar
Gasconsumption
m³/h
1
st
level
2
nd
level
l/h
bar
mbar
1
st
level
2
nd
level
1
st
level
2
nd
level
Heat
load
Q
B
Burner
inlet
tempe-
rature
Flue
gas
tempe-
rature
CO
2
Flue gas
losses
Soot level
Bacharach
scale
Heating
efficiency
Air
quantity
Mean air
outlet
tempe-
ratur
Power
consump-
tion fan
motor
kW
°C
°C
%
Q
N
kW
m³/h
°C (Air)
A/phase
Burner adjusted and set into operation an:
By:
Appliance installed:
in boiler room
in the space to be
heated free
attached to duct system of length approx.
The space heater / heating system has been installed and set into operation in accordance with the installation an operating
instructions. The customer has been fully instructed in the servicing and operation.
Date of delivery / installation
Signature and stamp of heating contractor
Checked by after sales service
on:
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