Manufacturer reserves the right to discontinue, or change at any time, specifications or designs without notice and without incurring obligations.Catalog No.04-53230010-01 Printed in U.S.A. Form 23XRV-5SI Pg CL-2 1016 10-14 Replaces: 23XRV-4SI© Carrier Corporation 2014- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - -CUT ALONG DOTTED LINE CUT ALONG DOTTED LINETESTING YES/NO DATE TO BECOMPLETED1. The cooling tower fan has been checked for blade pitch andproper operation.2. The chilled water and condenser water lines have been:a. Filledb. Testedc. Flushedd. Ventede. Strainers cleaned3. The chilled water and condenser water pumps have beenchecked for proper rotation and flow.4. The following cooling load will be available for start-up:a. 25%b. 50%c. 75%d. 100%5. The refrigerant charge is at the machine.6. Services such as electrical power and control air will be availableat start-up.7. The electrical and mechanical representatives will be availableto assist in commissioning the machine.8. The customer’s operators will be available to receive instructionsfor proper operation of the chiller after start-up.Concerns about the installation/request for additional assistance:I am aware that the start-up time for a Carrier chiller can take between 2 and 6 days depending on the model of the machine and theoptions and accessories used with it.Your contact at the job site will be _______________________________________________________________________________Phone number ______________________________________________________________________________________________Cell/Pager number ___________________________________________________________________________________________Fax number ________________________________________________________________________________________________In accordance with our contract, we hereby request the services of your technician to render start-up services per contract terms for thisjob on (Date). I understand that the technician’s time will be charged as extra services due to correcting items in thischecklist that are incomplete.Signature of Purchaser ________________________________________________________________________________________Signature of Job Site Supervisor ________________________________________________________________________________