www.heatmizer.com - Survey
Online Survey:
Your Name:
Company Name:
Address:
Street:
Apt./Suite:
City:
State:
e.g. KS, OK, etc.
Zip Code:
Phone:
(
)
E-Mail Address:
Boiler Information:
Manufacturer:
Size/Model:
Input, MBH:
Year:
Type:
Water, STM?:
Oper. Press:
Burner:
Manufacturer:
Size/Model:
Input, MBH:
UL or Serial Number:
Fuels:
Stack:
Hi-Fire Temp:
O.D.:
Height:
Horizion Breeching Size:
Probable Heatmizer Location:
Available Clearance Over Boiler:
Analysis:
Fuel Bill (12 Months):
Operating Hours:
Average Input, MBH:
Heat Sinks:
FW
Makeup
Cond Tank
DA
HW Tank
HW Loop
Temperature
° F
° F
° F
° F
° F
° F Supply
Other Data:
Continuous
%
Gal
Gal
Gal
° F Return
Batch
Grains
PSIG
GPH
Other Information:
Place Any Additional Information Here:
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