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GAS-FIRED WATER BOILER — Boiler Manual
Part number 550-101-233/0903
27
Installation certificate
Boiler model __________________
CP number ___________
Date installed _______________
Measured Btuh input ____________ Fuel: ❏ Natural Gas ❏ Propane
❏ Installation instructions have been followed.
❏ Check out sequence has been performed.
❏ Above information is certified to be correct.
❏ Information received and left with owner/maintenance person
Installer ________________________________(company) _____________________(phone)
________________________________(address)
________________________________(address) __________________________________
(installer’s signature)
Check-out/startup verification
7
Comments:
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________