Galvin Engineering CliniMix Lead Safe 100.00.71.00 Produkt-Installations-Manualline - Seite 17
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Version 2, 31 July 2020, 17 of 18
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APPENDIX
THERMOSTATIC PROGRESSIVE MIXING VALVE
COMMISSIONING AND/OR MAINTENANCE
Note: In all cases the Licensee is to submit this report within seven working days after commissioning and/or servicing
the valve.
1. Use a separate form for each valve.
2. The original report is to be given to the owner/occupier and retained on site for a minimum of 7 years.
3. All details are to be filled in. Incomplete reports will not be accepted.
PRINT ALL DETAILS or MARK WITH AN X IN BOXES TO INDICATE CHOICE
Name of
Facility
Street Address
Suburb
Phone #
Date
Make & Model of Hot Water Unit
Make of Mixing
Valve
Valve ID No.
Valve Location /
Building
Area serviced
by value
Outlet type
Basin
(mark with X)
Valve installed to requirements of:
1. The local water supply Authority
State
Contact Name
Work Order #
Model No
Size
Total No. of Mixing
Valves on Site/Building
Shower
2. The valve manufacturer / supplier
requirements
17
Post Code
Bath
3. The Australian Standards for
Plumbing and Drainage