Title Page
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Customer Name
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Contract #
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Address
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Conducted on
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Prepared by
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Equipment #
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Equipment Type
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Manufacturer
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Model #
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Serial #
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Voltage
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Phase
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Hertz
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Refrigerant
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Location of Unit
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Area Served
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Condenser Fan(s)?
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QTY/HP Condenser Fan(s)
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Supply Fan(s)?
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QTY/HPSupply Fan(s)
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Belt(s)?
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QTY/Size Belts
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Filter(s)?
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QTY/Size/Type Filter(s)
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Type of Heat/Capacity
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Is This a New Startup?
Blower
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Amp Draw
Compressor
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Amp Draw
Refrigerant
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Suction
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Discharge
Air
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Supply
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Return