AM SERIES BOILER INSTALLATION FORM

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AM SERIES BOILER INSTALLATION FORM Please complete one (1) form for each SITE containing AM Series BOILERS. Return to AERCO for warranty validation within 30 days of start-up. After completion, e-mail this form to: STARTUP@AERCO.COM. Completed By: Location Date: Installation Name: Street Address: SST Technician: Company: City, State, Zip: Phone #: AERCO Sales Rep: Registered Equipment Classification 399B 500B 750B 1000B Serial #s (Add additional in Notes if needed) General Installation 1. Is the relief valve piped to drain or within 12 of floor? Yes No 2. Is the condensate disposal system adequately sized and does it drain properly? Yes No 3. Is the condensate disposal system installed in accordance with the instructions in the latest version of the AERCO O&M? Yes No 4. Is there an electrical service switch at the unit? Yes No 5. Is there any electrical conduit or piping attached to the unit s sheet metal? Yes No 6. Does any electrical conduit, ductwork or piping impede the serviceability of the unit or the ability to remove the sheet metal covers? Yes No 7. Is there an adequately sized condensate neutralizer kit installed? Yes No a. If No, why not? 8. Have all electrical components been verified for proper grounding? Yes No 9. Has all communication wire been properly shielded? Yes No 10. Does condensate gravity drain? Yes No 11. Is a condensate pump used? Yes No Page 1 of 6

Boiler Gas Supply The questions below are related to the information in the AM Series Gas Supply Application Guide, GF-146-G 1. Type of Gas Supply: Natural Gas Propane 2. What is the static gas supply pressure to the boiler? 3. If the static pressure is more than 13 WC, is an external gas supply regulator installed? Yes No 4. What is the static gas supply pressure to the external supply regulators? 5. What is the make and model number of the external gas supply regulator? Make Model 6. Are the external gas supply vent regulator lines installed per local code & manufacturer s requirement? Yes No 7. If this is a lock-up style external regulator, what is the size of the orifice? 8. The external gas supply vent regulator lines are: Individually run 9. What is the BTU content of the gas? 10. What is the size of the gas supply header? 11. What is the length of gas pipe from the main meter? Manifolded together with other regulator vent lines 12. Are there any other appliances connected to the gas supply line? Yes No a. If Yes, please indicate the total BTU connected load: MBH 13. Is the gas supply system installed in accordance with the AM Series Gas & Supply Application Guide, GF-146-G Yes No Venting The questions below are related to the information in the AM Series Venting Application Guide, GF-146-V 1. What is the total vent length run? a. What is the total number of elbows in the ducting? 30 45 90 b. Are all elbows spaced 5 feet apart and 2 feet from the starter piece on the first elbow? Yes No 2. Is the vent sealed with RTV? Yes No 3. Is the vent pitched back toward the boiler (1/4" per ft. length) per the AM Series Venting Guide? Yes No 4. Venting material used is (choose one): AL29-4C Polypropylene PVC cpvc 5. Please describe venting configuration (check all that apply): Individual Vent Sidewall Termination Atmosphere (Natural Draft) Roof Termination Damper/Fan Breeched/Common (Units Vented Together) 6. Does the layout (overall length, pressure drop, breeching calculations, vent pipe wall thickness, etc.) comply with GF-146-V? Yes No Page 2 of 6

Combustion Air The questions below are related to the information in the AM Series Venting Application Guide, GF-146-V 1. Combustion air supplied through (check all that apply): Louvers to outside wall Horizontal ducting Direct or ducted combustion air Louvers to another room Vertical ducting Combustion air fan 2. What is the size of the ducting to individual units? a. What is the size of the common ducting, if applicable? b. What is the size of louvered opening? 3. Are there any draft inducers, combustion air fans or draft controllers on site? Yes No a. If Yes, list all that apply: b. Explain configuration: 4. Does the layout (overall length, pressure drop, breeching calculations, etc.) comply with GF-146- V? Yes No Hydronic Installation 1. If there are multiple units, are the units piped reverse-return? Yes No 2. Are balancing valves or circuit setters installed? Yes No 3. Are motorized isolation valves installed? Yes No 4. What are the minimum/maximum design flow rates through the unit? Min: GPM, Max: GPM a. Were the maximum & minimum flow rates verified? Yes No 5. Is the system (check all that apply): Water Source Heat Pump Primary/Secondary Pumping Other A Variable Flow System Used for Reheat Reverse Return Combination Control 6. What is the design system flow rate? 7. What is the design plant delta T? 8. Are strainers installed in both the primary and secondary loops? Yes No 9. What is the strainer mesh size? 10. What is the system pressure? 11. What is the primary loop GPM? 12. What is the secondary loop GPM? Page 3 of 6

Mode of Operation Individual Unit Control (choose all that apply): Remote Set Point (Analog) Combination Boiler/Water Heater Remote Set Point (Network/MODBUS) ACS (see below) Direct Drive Other: Indoor/Outdoor Reset Constant Setpoint Constant Setpoint Indoor/Outdoor Reset If ACS is used, the mode of operation is in use (choose one): Combination Control Panel (CCP) Network (MODBUS) Gateway ProtoNode If Network (MODBUS) is chosen above, the network type is in use (choose one): Other: If Building Automation System (BAS) Protocol is in use (choose one): BACNet (choose one): IP (ProtoNode Only) MS/TP PTP ARC156 (XPC Model Only) Johnson Controls - N2 LonWorks Page 4 of 6

Summary 1. Are the boiler(s) installed in accordance with AERCO guidelines and industry best practices? Yes No a. If No, please describe the issues. b. Who has been contacted? Please provide name & number for each person contacted (check all that apply)? AERCO Applications Engineer: General Contractor: Mechanical Contractor: Building Owner: Design Engineer: Plumber: Controls Engineer: Electrician: 2. Is there any conflict between the Installation & the Engineer s Specification or Design Plans? Yes No a. If Yes, please describe the issues: b. Who has been contacted? Please provide name & number for each person contacted (check all that apply)? AERCO Applications Engineer: Mechanical Contractor: Design Engineer: Controls Engineer: General Contractor: Building Owner: Plumber: Electrician: 3. Are there any conflicts or physical restrictions that will prevent the boilers from receiving proper preventative maintenance in the future? Yes No a. If Yes, please describe the issues: b. Who has been contacted? Please provide name & number for each person contacted (check all that apply)? AERCO Applications Engineer: General Contractor: Mechanical Contractor: Building Owner: Design Engineer: Plumber: Controls Engineer: Electrician: 4. Please outline any exceptions that have been granted by AERCO Applications Engineering for this installation: a. AERCO Application Engineering Sign Off: Page 5 of 6

ADDITIONAL NOTES: Page 6 of 6