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Date Installed: ______________________________________________
Boiler Model Number: __________________ Series: _________
CP Number(s):______________________________________________
Measured Btu or GPH Input: _____________________________
❏ Installation instructions have been followed.
❏ Check-out procedure has been performed.
❏ Above information is certified to be correct.
❏ Information received and left with owner/
maintenance person.
Installation and Service Certificate
Installer:__________________________________________________________________________________________________________________________
(Company) (Address) (Phone)
_________________________________________________________________
(
Installer’s Si
g
nature
)
Check off steps as completed:
❑ 1. Boiler properly filled with water?
❑ 2. Boiler piping checked for leaks (including
tankless heater, if used)?
❑ 3. System vents operating properly?
❑ 4. Boiler properly skimmed?
❑ 5. Air purged from oil piping? Piping checked
for leaks?
❑ 6. Flue cap in place and tightened? Burner
door closed, sealed and nut tight? Burner
plugged in and service switch on?
Obtain gas-tight seal to
prevent possible flue gas
leakage and carbon monoxide emissions,
leading to severe personal injury or death.
❑ 7. Proper draft and burner flame? Final
adjustment made with combustion
test equipment?
❑ 8. Test pressure control: While burner is
operating, move indicator on limit control
below actual boiler steam pressure. Burner
should go off. Raise setting on pressure
control above steam pressure and burner
should re-ignite.
❑ 9. Test low water cutoff(s): Follow control
manufacturer’s instructions for testing
procedures. Make sure burner goes off
when control responds to low water
condition. Burner should re-ignite when
proper water level is restored.
❑ 10. Test additional field-installed controls: If
boiler has additional operating control or
other controls, test for operation as
outlined by control manufacturer. Burner
should be operating and should go off
when controls are tested. When controls
are restored, burner should re-ignite.
❑ 11. Limit control set to system
pressure requirements?
❑ 12. Thermostat heat anticipator setting (if
available) set properly? Refer to “Connect
wiring,” page 19.
❑ 13. Boiler cycled with thermostat? Raise to
highest setting and verify boiler goes
through normal start-up cycle. Lower to
lowest setting and verify boiler goes off.
❑ 14. Observed several operating cycles for
proper operation?
❑ 15. Set room thermostat(s) to desired
room temperature?
❑ 16. Completed Installation and Service
Certificate below?
❑ 17. Reviewed Maintenance and Service
Manual with owner or maintenance
person and instructed person to keep
for future reference?
❑ 18. Returned all instructions provided with
boiler to its envelope and placed with boiler
for future reference?
26
Check-Out Procedure