Start-up Request Form for Boiler and Water Heaters

Please fill this form out completely, so we may efficiently service the piece(s) of equipment.
Date requested:  Mar 26, 2019
Job Information:
Request Start-Up Date:
Model/Serial #:
Installing Contractor:
On-Site Contact:
Contact Phone:
Contact Email:
Job Name:
Job Address:

Your completion of this Start-up Request form and the scheduling of start-up is indication that you are ready for start-up. If the technician arrives on site and you are not ready for start-up, you will be billed for the travel time to and from the job site from our office at a rate of $125.00 per hour.

Electrical voltage:  VAC
Electrical connection made to unit:   Yes    No
Gas connection completed to equipment:   Yes    No
Gas purged:   Yes    No
Supply gas pressure at heater:  inches of water column
Gas pipe diameter to unit:  in
Gas main size:  in
Gas Regulator 10 ft. from unit:   Yes    No
Regulator Manufacturer:  
System sensor installed:   Yes    No
Outdoor sensor installed:   Yes    No

Please check venting material for this application:
PVC    Double-wall "B" vent    AL294C    Power venting

Please check venting installation for this application:
Conventional vent    Direct vent    Vertical    Horizontal   
   Side-wall    Commonly vented
Openings for Combustion and Ventilation Air:   Yes    No   
Size of pipe:  
Size of opening in wall:  

Auxiliary Controls: (must be connected)
E.M.S./Building Management/Control Panel:
 (Name of Control)
Is the BMS hardware installed and ready to communicate/control the boilers? Yes    No   

  Please enter the code at left into this box:   

B. J. Terroni Co., Inc. is responsible for start-up of the above listed equipment at this jobsite and will not be liable for connections of water, electric, flue, and/or, gas piping. If any connection to the heater has either not been made or is incorrect, additional charges for the start-may be issued.

I have read and accept the terms above.

  NOTE: Everything must be filled out to complete the form.

B. J. Terroni Company, Inc. 3190 Tucker Road Bensalem, PA 19020T: (215) 639-3600F: (215) 639-3710 support@bjterroni.comPrivacy Policy
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