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PROJECT LOCATION :

AREA/ROOM SERVING :
SITE WORK DAY & HOURS :
DATE & TIME OF SURVEY :

EQUIPMENT: ___NEW ___REPLACEMENT ________ CAPACITY (HP)

___SPLIT TYPE ___CHILLED WATER


If Applicable
___WALL MOUNTED MAIN PIPE (Ø) : _____________
___FLOOR MOUNTED PIPE LENGTH (m) : _____________
ACCU ELEVATION (m) : _____________
___CEILING CONCEALED CEILING TYPE: ___FIXED ________________
___CASSETE TYPE ___OPEN ___ACOUSTIC ________________

REMARKS :

EE SUPPLY: ________VOLTAGE
________PHASE

REMARKS :

SCOPE OF WORKS:
_______SUPPLY&INSTALLATION
_______DISMANTLING AND HAULING OF OBSTRUCTIONS
_______ELECTRICAL WORKS
_______RESTORATION WORKS
_______TESTING & COMMISIONING

OTHER'S AS CLIENT SPECIFIED :

CLIENT/REPRESENTATIVE:

SIGNATURE OVER PRINTED NAME DATE

DELTA-T REPRESENTATIVE:

SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME

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