7
Installation certificate
Boiler model | __________________ | Comments: |
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) |
Part number | 27 |
