Utica Boilers UB95M-200 Installationsanweisungen

Boiler Model:

Boiler Serial Number:

Date of Installation:

Measured BTUH Input:

Boiler Location:

Altitude of Location:

Honeywell AM Kit Installed? (Yes/No):

Service Dates:

System Type (Give Brief Description):

Installation Instructions Have Been Followed

Checkout Procedure/Adjustments Performed

Maintenance/Service Issues Reviewed With Owner or Maintenance Person

Installation Manual Affixed Adjacent To or On Boiler

Installer/Technician’s Company:

Installer’s Name: 

Company Address:

Company Phone Number:

Installer’s Signature: