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For Standby, Automatic Emergency
And Prime Power Generators
It is required that both sides of this form be filled out
completely, signed where indicated and returned to
Baldor Generators within 30 days of initial Start-up
and test.
It is your responsibility to insure that copies are
distributed to:
Factory Distributor Customer
DISTRIBUTOR INFORMATION END USER / OWNER INFORMATION
Name: Name:
Address: Address:
Phone: Phone:
Model Number: Job Number:
RPM HZ P.F.
ڙStandby or ڙContinuous
KW Volts KVA Amps
Engine
Model#:
Generator
Model#:
Engine
Serial# :
Generator
Serial #:
List Distributor Installed Items: List Items Installed by Others:
Engine
Hour Meter
Power
Output
VOLTAGE CURRENT
Oil
Temp.
Oil
Pressure
Water
Temp.
Amb.
Temp.
KW
1-2 2-3 3-1 1 2 3 HZ
NO LOAD
Start-Up
Performed By:
Date:
Address: Technician:
Phone: Customer
Si
g
nature: