Installation certificate, Check-out/startup verification – Ultra electronic -155 User Manual
Page 27
GAS
-
FIRED
WATER
BOILER
SERIES
2 — Boiler Manual
Part number 550-100-026/0404
27
Installation certificate
Boiler model
__________________
CP number
___________
Date installed
_______________
Measured Btuh input ____________ Fuel:
❏ Natural Gas ❏ Propane
❏
Installation instructions have been followed.
❏
Check out sequence has been performed.
❏
Above information is certified to be correct.
❏
Information received and left with owner/maintenance person
Installer
________________________________(company) _____________________(phone)
________________________________(address)
________________________________(address)
__________________________________
(installer’s signature)
Check-out/startup verification
7
Comments:
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________