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P-18-516 FINAL & B/U nascryptlon. z CITY OF SALEM PLUMBING AND GAS INSPECTOR - - or S DATE; ADDRESS I S LICENSEE'S NAME/COMP NAME X S U� LICENSEE'S CONTACT NUMBER rPE OF INSPECTION M PLUMBING �J-GAS SPECTION TIME _ n ROUGH FINAL 0 GAS TEST T_ HER • CdMMENTS a • Vili�"� S J1 • Owl A/ 4 r f • PER IT ED 0-- MICH L J GUIDA SR PLUMBING & GAS INSPECTOR KNIGHT &KNIGHT XL START-UP CHECK 1KLIST Job Name: _._ Model Number. 02&5 Address: l _ -r pr' jf _ ._ -----_-_-- Serial Number: �.�,�� l e)q�� 3 02 7 C w�,r� City: 3u12w_ ST: llkA Zip: Start-up Date: OVERVIEW GAS,SUPPLY WATER&ELECTRICAL COMBUSTION Retrofit New Proiect Gas Pipe �t Water Pipe � Low Fire: Dia.(in.): Dia.(in.): O Of How many units are Is there an inlet gas At full fire,read and record- lockup regulator uu —!v installed at this location? ©Y CO ppm Boiler(s): the supply? &0 N Inlet Temp: CO, Q C) �O Water Heater(s): r If Yes,is it ten feet Q Y Outlet Temp: upstream from the P Q N Delta T: High Fire: Inspect gas pipe,regulator appliance? _-._ _._ _ g and meter sizing. Oz $ R .1 0 _!O Record in.of water column- Is it sized correctly Y Static Pressure: �o Supply VAC: CO ppm 13 1 F M for the Btu/Hr requirement? N Dynamic Pressure: "ftl Amp draw: CO, s 3 Comments/Corrections needed forgas supply,water or electricity: ® This Startup Sheet is for use only by a qualified heating installer/smite technician.Refer to the Installation and Operation Manual fur your reference. --'—--`— — '—'� Have this unit serviced/inspected by a qualified service technician,at least annually.Ras'lure to comply with the above could result in severe personal injury,death,or substantial property damage. CLEARANCES Measure and record(inches)the service clearances from the' nearest obstruction(min.24"required for service): VENTING(Select the venting option being used): Front:_ L Side: Top: , Q Vertical Direct Vent-two pipe vertical termination Rear: R Side: Horizontal Direct Vent-two pipe sidewall termination Comments/Corrections needed for service clearances: QConcentric Vent Vertical-single pipe vertical termination Q Concentric Vent Horizontal-single pipe sidewall termination N� ✓v Q Vertical Vent w/Sidewall Air-single pipe vertical termination w/ single pipe combustion air supply General Job Notes:_- 0 Vertical Vent wl Room Air-single pipe vertical termination — i Horizontal Vent w/Room Air-single pipe sidewall termination Air Inlet Air Inlet Total Eqv. START-UP PERFORMED BY:. Dia.(in.)- Material: Length ai.): Company: _._..._ .. .._.__..- -.. -- Name: -._ z�r�°- Flue Flue Total Eqv. Dia.(in.): Material: Length (ft.): Phone: _..._.._...____.—._. _—_____...__....__----__ .___..._..-.--_-._. START-UP APPROVED BY- Comments/Corrections needed or air inlet or vent piping-. Company: _--- Name: Phone: Send completed form to: � Intemal'J�: Email: 2tech�Lochinvar.wmI-ARWIPM0Sloe: Fax: (615)882-2963 nigh Erricivacy Water liteattn and boilers Routed: Mail: Service Dept/Lochinvar — The information on this form verifies operation of the Lochinvar product only. — Tech: _.._._._,._...-.,.__.. 300 Maddox Simpson Pkwy this does not imply other system components or overall system operation is certified.Component and App: Denied: El Lebanon,TN 37090 system verification should be performed by the designatedcommissioning agent or Installing contractor. KB-STARTUP REV A KNIGHT &KNIGHT XL START-UP CHECKLIST Job Name: Model Number: Address: � ___-- SerialNunber: /DG/5 9__(.__.,2j___�L__e__o. City: G -t ST: _ 'Lip: Start-up Date: OVERVIEW GAS SUPPLY WATER&ELECTRICAL 1 COMBUSTION Retrofit New�P'rro�)ect Gas Pipe j Water Pipe t Low Fire: ® Dia.(in.): --- Dia.(ter.): ! O, How man units o �t� Y are Is there an inlet gas At full fire,read and record- installed at this location? lockup regulator on O Y CO pPtt' Boiler(s): a the supply? ON Inlet Temp: CO, Water Heater(s): If Yes,is it ten feet ©Y Outlet Temp: - . upstream from the Hi Fire: Inspect gas pipe,regulator appliance? �N Delta T: � � e and meter siting. Record in.of water column Oz e !© Is it sized correctly © Y Static Pressure:0.q Supply VAC: ......... CO ppm for the BtufNr requirement? o N Dynamic Pressure: Ttl Amp draw: _______ CO, Comments/Corrections needed for gas supply,water or electricity: ® Thu.Slartap Sheet is for use only by a qualified heatingmstaller/srrvice technician.Refer to the Installation and Operation Manual for your reference. ifave this unit serviced(inspected by a qualified service technician,at least annually.Failure to comply with the above could result in severe personal in)ury,death,or substantial property damage. CLEARANCES Measure and record(inches)the service clearances from the nearest obstruction(min.24'requiredfor service): VENTING(Select the venting option being used): Front:..._. L Side: . Top: Q Vertical Direct Vent-two pipe vertical termination Rear. R Side: _ 0�p{- Horizontal Direct Vent-two pipe sidewall termination Comments/Corrections needed for service clearances: ® Concentric Vent Vertical-single pipe vertical termination 0 Concentric Vent Horizontal-single pipe sidewall termination ® Vertical Vent w/Sidewall Air-single pipe vertical termination w/ single pipe combustion air supply © Vertical Vent w/Room Air-single pipe vertical termination General Job Notes: - © Horizontal Vent w/Room Air-single pipe sidewall termination Air Inlet Air Inlet Total Eqv. START-UP PERFORMED BY: Dia.(in.): Material: Length(ft.): Company:_� � PVC,v -_—__----- -- -- Name: Flue Flue Total Eqv. Dia.(in.): Material: Length(ft.): Phone: _-_--__.---- CSTART-UP APPROVED BY: Comments/Corrections needed for air inlet or vent piping: Company: __--_------ Name: _----___- Phone: -- - -.. - - Send completed form to: j Internal Use: Tk � � St0�: t; Email: 2tech@Lochinvar.com Uxlfunw High Efrseienc Water Heater and Boilers Routed: Fax: (615)862-2963 Y hinvar — 1he informatiun on this form verifies operation of the Lochinvar product only. — Tech:,qai _._ ___..__........,. Service 17ePtr Ltx• _. " wn Pkwy. ibis does not imply other system components or overall system operation is certified-Component and Denied: 3�Maddox Sirup system verification should be performed the designated com niwoni t or installing contractor. " ❑ ❑ r �; 370� P r t6n "�'� tauOt� KB-STARTUP REV A Save'rhen Submit Form Lebasw-.