Conquest/Brigade Annual PM Form

Service Company Name *

Technician's Name *

Phone Number *

Date Performed *

Location Name (Include Store # if Applicable) *

Address *

City *

State *

Country *

Zip Code *

Serial Number *

Check for any piping leaks around pumps relief valves and tank connections. Take photos and note any leaks as a deficiency on the next page. *

Complete
Unable to complete

Check to ensure the area is free from combustible materials gasoline and other flammable vapors or liquids. *

Complete
Unable to complete

Visually inspect venting system for proper function deterioration or leakage. *

Complete
Unable to complete

Check for and remove any obstruction to the flow of combustion or ventilation air to the unit. *

Complete
Unable to complete

Check gauges monitors and indicators. *

Complete
Unable to complete

Check temperature and pressure relief valve. Refer to manufacturer's instructions on valve. *

Complete
Unable to complete

Inspect the condensate drain and ensure condensate is directed to an approriate condensate system or drain as required by local codes. Refill the condensate neutralizer with replacement media. *

Complete
Unable to complete

Check all operation of safety devices (e.g. CO Monitors). Refer to manufacturer's instructions. *

Complete
Unable to complete

Inspect burner and gas train components for wear or deterioration. ** Applies to Conquest models only ** *

Complete
Unable to complete
Not Applicable

Check the electronic-ignition system for quick ignition and proper flame signal. *

Complete
Unable to Complete

While water heater is on and operating shut off gas supply to force a flame fail. The unit will shut down, then try to light 3 times before a hard lockout occurs. Open the gas valve, then hold RESET in for 10 seconds to reset the lockout condition. *

Complete
Unable to complete

Open drain to remove any accumulated sediment. Start annually and adjust as local conditions and water quality require. *

Complete
Unable to complete
Not needed

Is the building recirculation pump functioning and in good repair? *

Yes
No - Needs Replacement

Is the expansion tank in good repair (free of rust. data plate legible) *

Yes
No - Needs Replacement

Is the expansion tank pressure set correctly based on incoming building pressure? *

Yes
No - adjusted while on-site
No - could not adjust

Document the final pressure of the expansion tank (PSI)

List unit serial number(s) here: *

Please upload a picture of the general site condition as it relates to the water heater. *

If any steps were unable to be completed explain why:

Please upload any pictures to support the above statements.

Please note any deficiencies or issues found during the PM that should be addressed immediately. This could be related to the water heater or room conditions (e.g. roof leak drywall damage general plumbing repair):

Please upload any pictures to support the above statements.