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INSTALLATION & COMMISSIONING REPORT

Boiler / Water Heater 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

Propane

Gas Supply Pressure (high re) _______ Inches w.c. Measured Rate of Input (high re) ____________ 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

gas piping

venting system

Fan and combustion components

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

Relief valve “try lever” test performed

Condensate trap lled

Condensate drain clear and free owing

Condensate Neutralization? Yes/No

Ignition Safety Shutoff test completed. Flame current reading - High re _______ µA - Low re _______ µA

Owner advised and instructed in the safe operation and maintenance of the boiler / water heater and system.

Information regarding the unit and installation received and left with owner

Combustion Readings - recommended, but optional (required for fuel conversion):

_____________ % O

______________ % CO ____________ ppm

Flue temperature _________ Return water temperature (measure simultaneously with ue temp.) _______________

Refer to website for registration.

Commissioning has been completed as listed on this report - Installer Signature _____________________________

IBC DC Series User Manual

Other manuals for IBC DC Series