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Boiler Model / Series
Part Number ____________
Natural gas input rate measured HIGH________ CFH / LOW________ CFH
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Boiler model _______________________________________________________________
_______________________________________
Number
____________
Measured Btuh input
_______________________
Installer
128
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OUNT GAS FIRED WATER BOILER
Boiler Start-Up Data
® ________ / Series ____
FUEL: Natural ____ LP ____
†
Installation instructions have been followed.
†
Checkout sequence has been performed.
†
Above information is certified to be correct.
†
Information received and left with owner/maintenance person.
______________________________ ____________________________
(address)
—
Boiler Manual
Date installed ________________
Btu Input ___________________
_________________________________
Date installed
CO # +LJK ¿UH BBBBBB
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Series ____________
_____________________________________
Part number 550-142-850/0716
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8201 W. Calumet Rd.
Milwaukee, WI 53223