Minnesota Pump Works

Installer Information

*Company Name

*Installer Name

*Phone

*Email

End-User Information

*Name

*Phone Number

*Address

*City

*State

*Zip

Station Inspection
Please refer to the Indoor Station Startup Checklist – Station Inspection Check for this section.

*Pump Serial Number

*Does this satisfy all Station Inspection Checks?
Yes No
If no, please explain in Final Notes section

Panel Inspection Please refer to the Indoor Station Startup Checklist – Panel Inspection Check for this section.

*Panel Serial Number

*Does this satisfy all Panel Inspection Checks?
Yes No
If no, please explain in Final Notes section

*Has the Panel been Cold Started?
Yes No

*Recorded Incoming Voltage

Run Test
Please refer to the Indoor Station Startup Checklist – Run Test for this section.

*Does this site meet all requirements of the Run Test?
Yes No
If no, please explain in Final Notes section

*Recorded Voltage

*Recorded Amperage

Submission

*This site’s startup has been completed with no issues.
Yes No

*Completion Date

*Final Notes

Image Upload
Please upload up to two images (Ex. Panel wiring, top of station, etc.)

E/One Station Installer Warranty Start-Up Form