Hot Water Boiler - Enquiry Form
YOUR NAME

COMPANY NAME

ADDRESS

TOWN/CITY

COUNTY

COUNTRY

POST/ZIP CODE

YOUR E-MAIL ADDRESS
**REQUIRED**
TELEPHONE

FAX NO.


REQUIREMENTS


NEW
RECONDITIONED
EITHER

FIRING ON
GAS
OIL (35 SEC DIESEL)
OIL (3500 SEC HEAVY)
ELECTRICITY
OTHER (PLEASE STATE)


ELECTRICAL SUPPLY

OUTPUT REQUIRED

INPUT TEMPERATURE

OUTPUT TEMPERATURE

PRESSURE


YOUR COMMENTS


PLEASE DOUBLECHECK ENTRIES AND THEN