Part number 550-100-090/0809
gas
-
fired
water
boiler
—
Boiler Manual
108
Ultra Gas Boiler Data Collection Sheet
Customer Info:
Maintenance Info:
Contact:
Name:
Contractor:
Phone:
Job name:
Model:
City, state:
CP#:
Distributor:
Installed:
System Components:
Boiler/System Piping Details (Please Sketch)
Near boiler pipe size:
Please note the placement of system sensors
Boiler circulator model:
DHW tank (yes/no):
DHW direct/system:
Dhw model:
Dhw pipe size:
DHW circulator model:
Is there air in system?:
Diagnostic Errors:
Control fault:
Ignition retries:
Manal reset CNT:
Auto reset CNT:
Software Versions:
Display:
Main micro:
Second micro:
Lockout History #1
Lockout History #2
Lockout History #3
HH:MM MM/DD/YY:
HH:MM MM/DD/YY:
HH:MM MM/DD/YY:
Status:
Status:
Status:
Manual reset:
Manual reset:
Manual reset:
If yes-description:
If yes-description:
If yes-description:
Auto reset:
Auto reset:
Auto reset:
If yes-description:
If yes-description:
If yes-description:
Priority 1:
Priority 1:
Priority 1:
Priority 2:
Priority 2:
Priority 2:
Priority 3:
Priority 3:
Priority 3:
Manual limit:
Manual limit:
Manual limit:
Auto limit:
Auto limit:
Auto limit:
Low WTR Cutoff:
Low WTR Cutoff:
Low WTR Cutoff:
Blower tach:
Blower tach:
Blower tach:
Flame Signal:
Flame Signal:
Flame Signal:
Outputs:
Outputs:
Outputs:
Gas valve:
Gas valve:
Gas valve:
Circulator 1:
Circulator 1:
Circulator 1:
Circulator 2:
Circulator 2:
Circulator 2:
Circulator 3:
Circulator 3:
Circulator 3:
Blower signal:
Blower signal:
Blower signal:
Additional heat demand:
Additional heat demand:
Additional heat demand:
Alarm:
Alarm:
Alarm:
Temperatures:
Temperatures:
Temperatures:
System supply:
System supply:
System supply:
System return:
System return:
System return:
Boiler out 1:
Boiler out 1:
Boiler out 1:
Boiler out 2:
Boiler out 2:
Boiler out 2:
Boiler in 1:
Boiler in 1:
Boiler in 1:
Flue 1:
Flue 1:
Flue 1:
Flue 2:
Flue 2:
Flue 2:
Outdoor:
Outdoor:
Outdoor: