Site Survey Form

Magnatech

Site Survey Form
Site Survey Form
Company Registration No.: 08762659 VAT No.: 182162910

Please complete all fields as accurately as possible.
Client Name
Installation Quotation Authorised by
Address for Installation
Contact Email Address
example@example.com
Contact Phone No Office
Contact Phone No Mobile
Boiler/Furnace/Dryer (please tick)
Gas Barrier Pressure
BoilerFurnace Location main building
Gas Flow Speed
Boiler Brand and Model Number
Annual Gas Consumption M ³MWhKWh
Output in KwHBTU VITAL
Average Gas Consumption for 1MWh of heating energy production M 3MWhKWh
Other
Do You Receive Gas Analysis in Your Energy Bill?

Fuel Intake Pipe Diameter in mm:
Section 1
Section 2
Stored Annual Consumption Data Available?

Fuel Intake Pipe Clear Length in mm:
Section 1
Section 2
Section 3
Burner Maintenance Agreement in Place?
Length of Intake Pipe Available for Magnet Mounting
Company Registration No.: 08762659 VAT No.: 182162910

PLEASE PROVIDE A DIAGRAM WITH MEASUREMENTS OF THE MAIN INLET FUEL PIPES AS NEAR TO THE COMBUSTION PLATE AS POSSIBLE. PLEASE ALSO PROVIDE PHOTOS OF THE INLET FUEL PIPES (AS PER EXAMPLES BELOW)

Please return the completed form to: info@magnatechsavesenergy.com
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