Installation And Service Certifi Cate - Weil-McLain ULTRA299-S4 Manual

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S 4
®
GAS FIRED WATER BOILER
ERIES
Installation and Service Certifi cate
Boiler Model
BTU Input
Installer
(Company) (Address)
Boiler Model
Fuel Natural ____ LP ____ CO High fi re
Was orifi ce changed? ______________________________________
Natural gas input rate measured _________________________ Btuh
Boiler Model
High Altitude yes ____ no _____ Adjust Outdoor
Manual Reset Temp
System Type
Max Supply
Min Supply
Max OD Reset
Min OD Reset
Modulate On Diff
Modulate Off Diff
Max On Time
Min On Time
Boost Interval
Pre-pump Time:
Post-pump Time:
Circulator 1
Circulator 2
Circulator 3
Maximum Rate
Minimum Rate
Circulator 1 on _______
Circulator 2 on _______
Circulator 3 on _______
140
— Boiler Manual
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GAS FIRED WATER BOILER
Series
❏ Installation instructions have been followed.
❏ Check-out sequence has been performed.
❏ Above information is certifi ed to be correct.
❏ Information received and left with owner/maintenance person.
CO High fi re
2
WWSD Temp
°F
System Type
°F Max Supply
°F Min Supply
°F Max OD Reset
°F Min OD Reset
°F Modulate On Diff
°F Modulate Off Diff
minutes Max On Time
— Min On Time
minutes Boost Interval
seconds Pre-pump Time:
seconds Post-pump Time:
on-off Circulator 1
on-off Circulator 2
on-off Circulator 3
%Rate Maximum Rate
%Rate Minimum Rate
off _______
off _______
off _______
— Boiler Manual
CP Number
(Phone) (Installer's Signature)
% CO
ppm CO Low fi re
Was gas valve throttle adjusted (Ultra-399) for propane? __________________
°F Add'l Heat Demand Type
°F Add'l Heat Demand Time
System Type
°F Max Supply
°F Min Supply
°F Max OD Reset
°F Min OD Reset
°F Modulate On Diff
°F Modulate Off Diff
minutes Max On Time
minutes Min On Time
minutes Boost Interval
seconds Pre-pump Time:
seconds Post-pump Time:
on-off Circulator 1
on-off Circulator 2
on-off Circulator 3
%Rate Maximum Rate
%Rate Minimum Rate
Circulator 1 on _______
Circulator 2 on _______
Circulator 3 on _______
Date Installed
Low fi re
2
1___ 2___ 3___ 4___
off _______
off _______
off _______
%
ppm
minutes
°F
°F
°F
°F
°F
°F
—
minutes
minutes
seconds
seconds
on-off
on-off
on-off
%Rate
%Rate