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79
Date
Model Number
Serial Number
Venting (PVC, CPVC):
Intake 90's (qty)
Vent size 3" or 4"
Exhaust 90's (qty)
Length of straight pipe
(intake)
Intake 45's (qty)
Exhaust 45's (qty)
Line Voltage
Polarity
Low Voltage
Electrical:
Size & material
Distance from meter
to water heater
Gas Line:
Static
Manifold
Running Inlet
Gas Pressure:
Size & Material
Length
Condensate Line:
Igniter Resistance:
Flame Sense Micro -Amps:
Venturi:
Exhaust Collector
Pressure:
Setting from Bottom in Turns
Positive Inches W.C.
LED Flashing Y or N Which One(s)
Combustion:
CO2 CO
Installation Site Contact Name &
Phone Number
Service Provider
Phone Number
Is trap provided Y or N
Installation Site Name & Address:
Length of straight pipe
(exhaust)
Spark Gap: ___________
Error Codes on Control Display (Direct Spark Ignition System Only): __________________________________
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