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INSTALLATION & COMMISSIONING REPORT
Boiler Details:
Model Number _____________________ Serial Number ______________________________________________
Date of Installation ______________ Address of installation __________________________________________
_____________________________________________________________________________________________
User contact information _______________________________________________________________________
Installer Information Company ___________________________________________________________________
Address ______________________________________________________________________________________
Phone/Fax/E mail ____________________________________________________________________________
__
Fuel
Natural Gas
Gas Supply Pressure (high fire) _______ Inches w.c. Measured Rate of Input (high fire) ____________ Btu/hr
Installation instructions have been followed and completed (Section 1 of Installation and Operating Instructions).
Check-out procedures have been followed and completed (Section 3 of Installation and Operating Instructions).
Leak testing completed
System Cleaned and Flushed (type of cleaner used) ________________________________________________
System Filled (type/concentration of any glycol/chemicals used) _______________________________________
Air purge completed
Relief Valve correctly installed and piped
Condensate trap filled
Ignition Safety Shutoff test completed. Flame current reading - High fire _______ µA - Low fire _______ µA
Owner advised and instructed in the safe operation and maintenance of the boiler and system.
Information regarding the unit and installation received and left with owner
Combustion Readings -
CO
_____________ %
2
Flue temperature _________ Return water temperature (measure simultaneously with flue temp.) _______________
Refer to website for registration.
Commissioning has been completed as listed on this report - Installer Signature _____________________________
Propane
gas piping
Condensate drain clear and free flowing
recommended, but optional
O
CO ____________ ppm
______________ %
2
venting system
Relief valve "try lever" test performed
(required for fuel conversion):
Fan and combustion components
Condensate Neutralization? Yes/No
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