Beckett CG4 User Manual download pdf (Page 27)

Contractor Start-Up Form

Installation Name:_________________________________________ Installation Date:___________________

Installation Address:_________________________________________________________________________

Start-Up Company’s Name_________________________________ Phone:__________________________

Name of Technician_________________________________________________________________________

■ Appliance (Below information can be obtained from appliance name plate)

Manufacturer:______________________________________________________________________________

Type (circle one): [ Boiler / Furnace / Other ] Model #:_______________ Serial #:____________________

Input MBH:_______________ Original Appliance Designed for (circle one): [ Oil / Natural Gas / Propane ]

Output MBH:______________

Limits

Limit Model No.

(Indicate n/a if not required by the appliance manuf.)

Operation Veried

Temperature YES / NO

Pressure YES / NO

LWCO YES / NO

Other Limits YES / NO / n/a

■ Burner

Fuel: [ Natural Gas / Propane ] Model #:________________ Serial #:_________________________

Combustion Head: [ F3G / F4G / F6G ] Fuel Orice Size:________ Air Shutter Setting:____________

Air Band Setting:____________ [ or Blank Band Installed ] Bafe: [ Installed / Not Required ]

■ Chimney/Smoke Pipe

Chimney Type:[ Masonry / Metal Vent / Direct Vent ] Location (circle one): [ Inside / Outside ]

Chimney Height:_____________ Flue Pipe Size:______________ Flue Pipe Length:________________

Number of Elbows:____________ Conrm Double Acting Draft Regulator Installed: [ Yes / No ]

Thermal Safety Switch Installed [ Yes / No ] Voltage: [ 120V / 24V ]

Gas Supply Piping

Pipe Diameter:________ Length of Pipe from Burner to Meter:_________ Number of Elbows:__________

Gas Pressure to Burner Gas Valve While Burner is Operating ____________ Inches W.C.

■ Combustion Readings

2 :

_________% CO:__________ PPM CO

2 :

_________% Stack Temperature (325°F MIN.):__________°F

Manifold Gas Pressure:______________ (Inches W.C.) Draft at Breech___________________________W.C.

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Beckett CG4 User Manual Page 27