EQUIPMENT PERFORMANCE INSPECTION Submit All Completed Forms To Authorized Service Company Vulcan Hart Company P O Box 696 Louisville KY 40201 Attn Product Service Department Name __________________________________ Address ________________________________ City ___________________ State _________ Phone _____________ ZIP __________ Section 1 Customer Information Customer ________________________________ Address _________________________________ City ____________________________________ Contact Name __________________________ Phone _______________________________ State _______ Zip ________ Caution The following procedures should only be preformed by qualified and authorized service technicians It is assumed that the servicing technician is aware of safety precautions and familiar with equipment operations Model __________________ Serial __________________ 1 Section 2 Equipment Data Plate Inspection Type of Gas ____________ Voltage _____ Phase _____ BTU Rating __________ Date Installed ________ Section 3 Inspection Inspect for shipping damage Did customer dealer report shipping damage to the shipping company within 15 days after receipt of machine or else forfeit possible claims Comments COMPLETED YES NO Section 4 Installation 3 Gas Connections ______ Amps a Operating pressure __________ WC _________ Size ______ Amps Checked operating gas pressure with all equipment on ______ Amps _______ WC 2 Electrical Connections a Voltage ________ Volts _________________ Volts _________________ Volts 4 Check the following columns if applicable a Verify equipment is level b Verify proper type of gas c Verify proper pressure regulators installed d Verify gas pipe line supply size is adequate e Verify gas supply pressure is adequate f Check gas connections for leaks g Verify proper operating gas pressure with all equipment on adjust if required h Verify proper voltage for equipment supply i Verify electrical connections are correct j Check ventilation k Check thermostat operation calibrate if needed l Check pilot and burner adjustments m Check functional operation of doors lids valves etc n Check overall operational performance of equipment o Advise customer of cleaning and maintenance procedures p Advise customer of water quality requirements q Explained warranty terms YES NO Comments Results CONTINUED ON PAGE 2 F 32064 Rev A 10 03 Page 1 of 2
EQUIPMENT PERFORMANCE INSPECTION Submit All Completed Forms To   Authorized Service Company  Vulcan-Hart Company P.O. Box ...
Section 4 Installation Continued 5 Water Connections a What is the filter Model Name ___________________________________________ b Is the water filter connected to an un softened cold water line Yes No c Is the filtered water connected to the TREATED WATER inlet on the unit Yes No e Is the cold unfiltered water connected to the UNTREATED WATER inlet on the unit Yes No g What is the water pressure going into the filter ________ PSI h Is the drain connected independently to an open gap type floor drain Yes No Note If is very important that the drain run independently to an open gap floor drain as described in the Installation Manual There should be no restrictions or other equipment coupled to the drain line Failure to conform to these specifications may cause the unit to not work properly Drain connect must not be located under the unit i Was the filter water checked with the test strip provided Completed YES NO Were the results sent to Vulcan Hart Completed YES NO Acceptance We understand that in order to qualify for warranty coverage only service companies authorized by Vulcan Hart and genuine O E M parts shall be used for any repairs Customer Acceptance Signature ____________________________________Date _________________ I verify that I have conducted a complete checkout of the above equipment Service Representative Signature ___________________________________Date _________________ NOTE Additional manuals are available from our website www vulcanhart com F 32064 Rev A 10 03 Page 2 of 2
Section 4    Installation  Continued  5.  Water Connections a. What is the filter Model Name  ____________________________...