APPENDIX A
OWNERSHIP DATA
MODEL NO:
...............................................................
SERIAL NO:
...............................................................
INSTALLATION DATE: ......................................................
COMMISSIONING DATE:
INSPECTION/EXAMINATION
Name
................................................
Signature
COMMISSIONED BY:
(PLEASE PRINT)
COMPANY NAME: ...........................................................
TELEPHONE NO.: .............................................................
SERVICE PLAN: ...............................................................
REPAIR/MAINTENANCE (IF ANY)
Date
29
......................................................
Summary Remarks