Reciprocating Compressor Registration Order Number Distributor Name * Distributor Phone Number * Distributor Email * Owner Information Company (End User Name) * Contact Name * Street Address * City * State/Province Location * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Phone Number * Email * Compressor Information Compressor Model * ML Series CA Series CT Series CTS Series (single Stage & Portables) CC Series (Climate Control) OL Series (oil-Less Reciprocating) CW Series (Large Industrial) Vacuum Pumps Nx Series RS Series ZW Series ECO-Series Scroll GSV Series AF Series SE / SEG Series Dryers -Please Select- Compressor Part Number * Compressor Serial Number * Pump Serial Number Pump Serial Number (Duplex Units) Date of Purchase * Date of Start Up * Was this compressor started up by an authorized FS-Curtis Distributor? * Yes No Industry * Agriculture Airplane Servicing Auto Aftermarket Boat Servicing Chemical Computer & Electronic Dairy Education Electrical Equipment Manufacturing Food and Beverage Furniture and Cabinet Manufacturing General Manufacturing General Service Laboratory Machinery Manufacturing Medical Metal Manufacturing Metalworking Mining Oil & Gas Paper Processing Plastics & Rubber Postal Power Generation Printing Rail Snowmaking Textiles Transportation - Equipment Manufacturing Warehousing Waste Management Water Treatment Woodworking Describe if neccesssary Please describe your typical hours of operation: Days per week * 1 2 3 4 5 6 7 Hours per day * 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Installation Requirements The compressor may not be operated outdoors. The installation location is level and is not subjected to abnormal vibrations. The unit should be in a clean, well-lighted area that will not be exposed to ambient temperatures exceeding 104°F The machine is easily accessible and can be accessed from all sides. Allow at least three (3) feet clearance on all sides of the compressor to facilitate maintenance and allow for free circulation of air. There is sufficient ventilation and the intake of media other than cool, dry and dust-free cooling air is forbidden. There is a fusible disconnect power supply available with voltage deviations of less than 10%. The machine is not subjected to an explosive or corrosive atmosphere. Overall appearance and condition of location is in good condition. By checking this box, you verify that all INSTALLATION REQUIRMENTS above has been adhered to. Safety Requirements Read Owner's manual and/or instruction manual to understand compressor operation and controls prior to starting. All machine guards, shields or screens are in place, secured and have not been altered. Check that all safety devices are fully functional and correctly installed before starting work. Do not operate the compressor in excess of its rated pressures and speeds indicated on the compressor nameplate. All electrical connections are in accordance with applicable local, state and federal regulations. Unit is level and the entire perimeter is in contact with the floor. By checking this box, you verify that all SAFETY REQUIRMENTS above has been adhere to. Pre-Start Requirements To protect the vibration isolators underneath the motor/airend assembly during transport, there are red spacers that hold the assembly in place. Make sure these spacers are removed before first startup of the compressor (Scroll product only). Oil level has been checked and is at the correct level. Check all connections to make sure they are in-stalled correctly and all hardware are properly fastened. Belt tension and motor alignment has been checked and are aligned correctly (Recommended). Intake air filter has been checked and is installed correctly and is free of obstruction. By checking this box, you verify that all PRE-START REQUIRMENTS above has been adhered to. Electrical Connections Requirments The machine and the power source are connected through a fusible disconnect and properly grounded in accordance with the National Electric Code and any other applicable codes. The power supply is adequate and free of loads that will cause an abnormal voltage condition during compressor operation. Motor leads have been checked for correct connection and are properly taped and wrapped (Required inspection on CW Series). Check all electrical connections to make sure they are in-stalled correctly and tighten if necessary. Overload and heater size has been checked and is correct for motor protection. By checking this box, you verify that all ELECTRICAL CONNECTIONS REQUIRMENTS above has been adhered to. Start Up Requirements Check correct direction of rotation of airend and motors by briefly starting the compressor. (Momentarily bump start to check rotation. If motor is allowed to run in wrong rotation, air end damage will occur and warranty will be void). Check that all safety devices are fully functional and correctly installed before starting work. Controller has been powered up and is functioning properly (If Applicable). Compressor controls have been adjusted for correct operation and operating pressure. Compressor has been checked for unusual noise and abnormal vibration. Check the compressor for air / oil / water leaks and correct as necessary. By checking this box, you verify that all START UP REQUIRMENTS above has been adhered to. Operational Requirments Line Voltage (Before Starting): L1: _______________ L2: _______________ L3: _______________ Line Voltage (At Max Pressure): L1: _______________ L2: _______________ L3: _______________ Full Load Amps (At Max Pressure): L1: _______________ L2: _______________ L3: _______________ Unload Amps (At Min. Pressure): L1: _______________ L2: _______________ L3: _______________ **NOTE: Set overloads according to measured amps, which may differ from factory settings. Ambient Temperature: _____________⁰F Air/Oil Temperature: _____________⁰F Water Service Temperature: _____________⁰F Pressure Settings: Cut In: _____________ Cut Out: ___________ Modulation: _________ Duty Cycle: ___________________ System Air Receiver Size: ________________ Gallons: Air Treatment Equipment Installed: __________Yes __________No Distributor/Customer Review Requirements Reviewed correct operating procedures, routine maintenance requirements, and oil sampling requirements with Owner. Reviewed controller operation, parameters, and settings with Owner (Scroll product only). Reviewed Standard Manufactures Warranty and responsibilities for coverage with Owner. Reviewed Extended Warranty and responsibilities for coverage with Owner. By checking this box, you verify that all DISTRIBUTOR/CUSTOMER REVIEW REQUIREMENTS above have been adhered to.