Water Heater Questionnaire
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Heater situation
Replace Existing
Add to Existing
Move Heater to different location
Eliminate Heater and cap off as needed
Need water heater repaired if possible
Other
Misc Information
Type of Water Heater you have now (check all that apply)
Natural Gas
Power Vent
Electric
Tankless
Not Sure
Other
Manufacture of existing water heater
Not Sure
Bradford White
AO Smith
State
Rheem
Richman
GE
American
Master Mechanic
Other
Heater Model Number (no worries if you do not have)
Heater Serial Number (no worries if you do not have)
Take Picture of Rating Plate of existing water heater if possible
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Venting of existing water heater (Gas combustion)
Goes into chimney with furnace
Goes into chimney by itself. (furnace use to be vented in chimney but now is vented outside with PVC Piping)
Goes to class B venting to outside
Water Heater is vented to outside with PVC Piping
I may need a chimney liner.
Not Sure how its vented.
Other
Water Heater Electrical Needs
Need electrical outlet for power vent water heater
Need upgrade or relocate power source for electric water heater
Not sure what my electric needs will be
No electrical needs are necessary
Other
Water Line supplying water heater
Copper
Galvanized
CPVC plastic
PEX plastic piping
Not sure
Other
Water shut off valve for heater
Gate Valve
Ball Valve
Globe Valve
Not sure
Other
Is shut off valve operational and code compliant
Yes
No
Not sure
Other
Is gas piping sized correctly with code compliant shut off valve and proper piping with no leaks
Yes
No
Not sure
Other
When selecting a water heater what is most important to you (please select all that apply)
Never ever ever running out of hot water
Highest Gallon Per Minute capacity (for filling tubs or showers with multiple heads/body sprays)
Lowest possible operating cost
Extended warranties on the product and labor
Size (it can fit in the location it needs to. EX: under a cabinet or in a closet or ???)
I would really like this water heater to last longer than average (10 years for tank and 20 years for tankless)
Not sure. Probably a combination of some of the above. I'm hoping to discuss with the tech when he's on site
Most cost effective (I'm looking for the lowest price possible for heater and install. I really don't care or need any other benefits as long as it meets code)
Other
Water Source
City Water
Well Water
Not Sure
City/Community Well
Other
Water Treatment Devices (please select all that apply
Water Softener
Whole House Carbon Filter
Iron Filter
Scale Inhibitor
Reverse Osmosis
UV Filtration
Not Sure
Other
Any additional information on water treatment devices you may have or consider getting that may affect the hot water system.
Number of Bedrooms
Number of Bathrooms
Number of Showers
How many people live in the home
Type of Tub/shower systems (select all that apply)
Standard size tub
Deep soaking tub
Whirlpool tub
2 person whirlpool tub
Multi shower head/body spray system
Other
Information on any high volume/capacity hot water requirements
Is your water heater under manufactures warranty?
Yes
No
Not sure, have the tech check when on site.
Other
Approx Age of Water Heater
Under 6 years old (Typical Manufacture Tank Failure warranty)
7 to Ten years old years old (Upgraded Warranty Option)
11 years or older (Typically outside of manufactures warranty)
Not sure how old this heater is
Other
Water Heater Status (check all that apply)
Tank is leaking
Not Heating
Not enough hot water
Smelly Water
Use to be smelly but not anymore
Just getting old and want a new one
Want a more efficient heater
Money is no object I just want the latest and greatest that is available
Other
Misc Information
Sense of Urgency
Creating Structural or Water Damage
I NEED HOT WATER ASAP!!!
I can handle it for a bit but the sooner the better.
No rush I just want to upgrade or replace what I have
Other
Water Heater Removal (check all that apply)
I will drain existing water heater
I will need you to drain existing water heater
I will remove existing water heater from premise once its disconnected
I will need you to remove existing water heater from premise
Not sure, we'll figure this out once the tech is on site.
Other
Water Heater Location (check all that apply)
Basement
First floor
Second Floor
Third Floor
Crawl Space
In kitchen cabinet, under counter top.
Closet
Not sure
Other
How accessible is the Water Heater (pathway to remove existing and bring in new heater)
Clear pathway with no stairs
Clear pathway with one set of stairs
Clear pathway with turning stairs
Limited accessibility (may ave to move items to remove heater)
Extreme limited accessibility (not sure how your going to get this in or out)
Not Sure (tech will assess once on site)
Other
Location of nearest floor drain
Within 25 feet of heater
Over 26 feet away
Not sure where the floor drain is.
The floor drain is not accessible
Not sure how your going to drain the heater
No worries I'll have the heater drained for you.
Other
Type of Water Heater you would like installed
Not sure, You're the expert, I'll go with what you recommend
30 gal gas
40 gal gas
50 gal gas
75 gal gas
Power Vent
Tankless Water Heater
30 gal electric
40 gal electric
50 gal electric
High Efficiency Heater (may cost more but will save in operating costs)
Upgraded warranties (gives you peace of mind)
Other
Preferred Manufacture of Replacement Water Heater
Not sure, You're the expert, I'll go with what you recommend
Bradford White
AO Smith
Rheem
HTP
I will provide my own water heater.
I will make sure the water heater is delivered
I need you to make arrangements to have the water heater delivered
Other
Misc Information
Optional Water Heater Accessories (Check what you may be interested in)
Hot Water Circulating System (so you don't have to wait for the hot water at any faucet)
Thermostatic Tempering Valve (Heater acts 50% bigger. EX: 50 gal heater will operate like a 75 gal heater)
Anti Scale Inhibitor ( Heater will operate more efficient and extend water heater life)
Auto Emergency Shut Off System (will sense if heater is leaking and will automatically shut off water valve to prevent any flooding)
10 year parts and labor heater warranty
Upgraded drain valve to help in assisting flushing of the tank for maintenance.
Upgraded power anode rod (extends water heater life and eliminates smelly hot water)
I may be interested in some of these. Please have the tech go over them with me when he is on site.
Other
Misc Information
Pictures or Documents you think that may help.
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