Conquest/Brigade Annual PM Form

Service Company Name *

Technician's Name *

Phone Number *

Date Performed *

Location Name (Include Store # if Applicable) *

Address *

City *

State/Province *

Country *

Zip Code *

Check for piping leaks around pumps relief valves and tank connections. Repair if found. *

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. Redil the condensate neutralizer with replacment media. *

Complete
Unable to complete

Check all operation of safety devices. Refer to manufacturer's instructions. *

Complete
Unable to complete

Inspect burner and gas train components for wear or deteriorationn *

Complete
Unable to complete

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

Complete
Unable to complete

Test the electronic-ignition flame failure detection system. While heater is heating shut off gas supply to kill the flame. The heater would shutdown and try to light 3 times hard knockout. Open the gas valve and the hold RESET in for 10 seconds to reset 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

List unit serial number(s) here: *

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.

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