Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
System
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Bthu
System
Indoor
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Style
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Model
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Serial
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Location
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Heater
- 5kw fused
- 5kw n/fused
- 8kw fused
- 8kw n/fused
- 10kw fused
- 10kw n/fused
- 15kw fused
- 15kw n/fused
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Refrigerant
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Voltage
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Motor
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Capacitor
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Blower
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Filter
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Return location
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Overall condition
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Coil
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Coil
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Metering device
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Drain
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Notes
Outdoor
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Style
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Model
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Serial
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Location
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Refrigerant
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Voltage
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Motor
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Capacitor
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Fan bearing
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Coil
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Coil
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Metering Device
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Notes
Sign
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Customer Signature
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Technician Signature
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Date