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Electro Freeze Pre-Start-Up Form

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Pre-Start-Up Checklist

The following information is needed before the demonstration and start-up of Electro Freeze Equipment. Please verify all information and submit this form to schedule your start-up date.

Requested Start-Up Date *

Layout

Company/Location *

Store #

Street Address *

Address Line 1

Address Line 2

City

State

Zip Code

Contact Name *

First

Last

Layout

Phone *

Email *

Equipment

Layout

Model #

Serial #

Connections

Have the proper electrical requirements been met? *

Is the water line installed? *

Yes
No
Not applicable

Neccessary Start-up Items

Start-up box on site and available *

Is the product available and ready for install? *

Do you have a preferred authorized EF service tech you prefer *

Service Tech Name

First

Last

Layout

Phone

Additional Contacts

Contact 1

Layout

Name

Company

Phone

Contact 2

Layout (copy)

Name (copy)

Email (copy)

Company (copy)

Phone (copy)

Contact 3

Layout (copy) (copy)

Name (copy) (copy)

Email (copy) (copy)

Company (copy) (copy)

Phone (copy) (copy)

Call 24 hours in advance of the scheduled appointment to cancel. Takes 2-3 weeks to get an appointment after this form is returned.

I have confirmed all the required information to schedule the start-up. If the proper power, water, mix, or personnel requirements listed are not available at the time designated and result in a second trip to finalize installation I agree to pay the trip charges.

Signature

Printed Name *

First

Last

Printed Title *

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