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
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 and system.
Information regarding the unit and installation received and left with owner
Combustion Readings:
CO
2
_____________ % O
2
______________ % CO ____________ ppm
Flue temperature _________ Return water temperature (measure simultaneously with ue temp.)
_______________
Installers: send this completed sheet - Fax to 604 877 0295 - or - scan and Email to info@ibcboiler.com, and earn an extra
year’s Parts Warranty coverage (User to submit corresponding Installation Record from User Guide).
Commissioning has been completed as listed on this report - Installer Signature _____________________________
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