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<br />C~ <br /> <br />WARRANTY INFORMATION SHEET <br />1 r~ ~ t' <br />THIS SHEET MUST BE COMPLETED, SIGNED AND RETURNED j ' s,_I{~~ <br />WITHIN 72 HOURS OF INSTALLATION to: ~' <br />Exodyne Electric Motors, Inc. • 9229 South Hardy Drive • Tempe, Arizona • 85284 <br />Phone: 1-800-782-7855 • Phone: (602} 496-6300 • Fax: (602) 496-0132 <br />~~ m ih ~ ~v,~~o <br /> <br />Motor Manufacturer ~ Model# Serial#Q 1796 <br />Horsepower f ~ Vohege ~ G Diameter ' <br />Pump Manufacturer G,O ~ ~ ~ ~ Model # ~ o o ~ / D A L.C - <br />Rated rJSD- LO O GPM at (~rj ~ feetfrom top <br />What is the pump's condition? (chedcone) H New ^ Remanufecturad O Other (Is pump in "as-new' condition? O Yes O No) <br />It a Byron Jackson pump is driving otherthen ~ Syron Jackson motor, is there a throttle bearing? ^ Yes ^ No <br />Does [he pumdmatgr system operate Wrrbnuously/non-stop? ^ Yes B No (lndie~e below how motor is comrolled) <br />(check onej ^ ManuelSwip:A O Flow Switch ^ Pressure Switch ^ Timer O FloaVLevel Control O Other <br />Mow often does the system cycle? times per hour <br />WELL OWNER C ~r3 ~ • <br />Name C ,t...1 Phone Q 7U. S' 2- K- r{'/ 7~ <br />Street Address T ,o7 ,t43 So4TN City ~°RA~ ~ Stets ~ Zip $~~` <br />WELL LOCA710N <br />city Sam, cAdnry state <br />Well Identifier - <br />Contact Name ~% ~ A, ~~f. Tree Mr Fo .n M) Phone Sq,., <br />INSTALLATION - - <br />mstauing Company phone 675 -42t) <br />StreatAddress t2~ 1' Ciry Q ~ State ~ Zip g~ 64 <br />Contact Name l~rtar2 ~C.wt~) Title s~ <br />ru n <br />Date of InstallaGo_n - Is this a new installation? ^ Yes ID No (Explain) - <br />~ ~ l ., ,, r <br />WELL CONSTRUCf10N <br />Well diameter ~ in. Depth tL Is well cased? g Yes (Provide irdortne6on requested below) ^ No <br />Casing diameter 2 y u in- Casing length ([. Casing material ~ Steel ^. Stainless Steel ^ Plastic <br />Casing construction (check one) q Sogd ^ Screened ^ Pertoreted (Indicetewhere ) <br />WATER INFORMATION <br />Water level ~ ~~ / feetfrom top Water temperature: ^ °F •C ~9, 3 <br />Drewdown level ,~j0(7 feet after pumping et ,5-pQ GPM or GPH for hours a <br />Pump motor system is sat feat from tap System is hung from ~ Steel Pipe Q Rigid Plastic ^ Flexible Plastic <br />Is there a shroud around the motor? ^ Yes (Indicate diameter in.) O No <br />Are there check valves in the systemT O Yes pndicete number of valves ) ho <br />Describe check valves <br />Is there a pressure swit~7 ^ Vas (Provide iMormation requested below) ~ . o <br />Manufacturer Model ~ Sire <br />EEMI Rev-'{2197 <br />Warranty No. E10245 <br />Page 1 of 2 <br />s~TTaN eLSt60 SO LZ Flew <br />Z•d S66T bZ8 OL6 <br />