UTICA BOILERS MAH-100 Manual page 83

INSTALLATION AND CHECK-OUT CERTIFICATE
Boiler Model Serial # Date Installed___________
Measured BTU/HR input____________
 Installation instructions have been followed
 Checkout procedure and adjustments performed
 Maintenance and Service issues reviewed with owner/ maintenance person
 Installation booklet affixed on or adjacent to boiler
Installer (Company)
Address
Phone
Installer's Name
Signature
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240013354 REV B [09/15/2021]