Company*

Startup Date*

City*

Province*AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Territories

Technicians Name*

Company*

Address*

City*

Province*AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Territories

Postal Code*

Email Address*

Compressor Model*

Serial Number*

Compressor Room Temperature (C)?*

Description of compressor location:*

How much distance around compressor (back,sides,front,above)?*

Diameter of air piping from air receiver to shop?

Amp service available to unit (amps)?*

Which is utilized, a disconnect or breaker?*

What is the size of the disconnect or breaker (amps)?*

If it is a disconnect, type of fusing?

If it is a disconnect, what is the size (amps)?

Size and length of wiring to unit?*

Is the motor rotation correct?*

What is the voltage measured at the compressor?*

What is the maximum amp draws at maximum pressure (amps)?*

Load pressure (PSI)?*

Unload pressure (PSI)?*

What is the voltage measured at the compressor?*

What is the maximum amp draws at maximum pressure (amps)?*

Load pressure (PSI)?*

Unload pressure (PSI)?*