INSTALLATION & COMMISSIONING REPORT
Unit 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 unit and system.
Information regarding the unit and installation received and left with owner
Combustion Readings - recommended, but optional (required for fuel
conversion):
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.
Commissioning has been completed as listed on this report - Installer Signature _____________________________
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