EMP WP29 - Appendix B, WP29 and WP32 Installation Approval Registration and Check Sheet; Installation Approval

Appendix B, EMPower Connect Service Tool
© 2013 EMP, Inc 26
Appendix B, WP29 and WP32 Installation Approval Registration and
Check Sheet
To be Completed by EMP
Installation Approval #
Date Submitted
Reviewer
Approval Date
Approval Signature
Comments
To Be Completed By Customer/Reviewer
Organization
Product Information
Street
Pump Hardware Number
City
State/Prov
Pump Hardware Serial Number
Country
Zip Code
Pump Programmed Assembly (PA) Number
Contact
Phone
email
Installation Description, (Vehicle Type, Fluid Type, Mounting Location, Flow Requirements)
I certify that the pump will be used in as described in this installation approval request. I
understand that any deviation from use as described here may void the warranty on the pump.
Requestor Name Request Date
Requestor Signature
Submit Completed Forms to:
EMP
2701 North 30
th
Street
Escanaba, Michigan 49829
Phone: 906-789-7497
www.emp-corp.com
Service@emp-corp.com