Submittal Sheet

Eemax Electric Tankless Water Heater - Customer Sign-off
Used to confirm configuration for the “made to order” water heater within the following
series: Eemax Three phase, ProAdvantage and De-Ionized (triple module).
If you need assistance please contact Eemax Inc @ 1-800-543-6163
Purchase Order Date:_____________________________________________________________________
Customer Purchase Order Number:__________________________________________________________
Project Name and location:_________________________________________________________________
Project Contractor:_______________________________________________________________________
Model Number and quantity on order:________________________________________________________
Voltage (VAC)
208V 3-phase(delta)
480V 3-phase(delta)
480/277 3-phase
(wye)
Kilowatt (kW)
18
20
24
32
PLEASE CHECK EACH BOXED SECTION & SIGN BOTTOM OF PAGE
Rev. July 2017
Wiring Configuration
Delta –
3 conductors,1 ground, no neutral
WYE
3 conductors, 1 neutral, 1 ground
NEMA
Cabinet
Selection
N4
NEMA 4
(powder coat gray)
N4X
NEMA 4
(304 SS)
N4X6
NEMA 4
(316 SS)
Nema Cabinets & Options below are special order, and are available for an additional cost.
NEMA
Cabinet
Options
FP
freeze
protection
EDS non-
fused
electrical
disconnect
FDS fused
electrical
disconnect
EP explosion
proof C1D2 –
purge and
pressurize
controller
GFCI
ground fault
circuit
interrupter
SK stand kit
for
freestanding
install
SB
siren and
beacon
These units are custom made. Upon return of this form, order is NON-CANCELABLE and the items are NON-RETURNABLE.
Orders will be released to production when this form is signed & returned.
Please sign below as acceptance of these terms, conditions and installation requirements.
Return via fax to [phone] or email to [e-mail] to authorize production.
Print Name:______________________ Signature:_______________________
Title & Company:____________________________________ Date:_________
IS HEATER TO BE USED TO REHEAT A RECIRCULATION LOOP_________________________
IF YES, PLEASE CONTACT APPLICATIONS DEPT. AT 203-596-2524 FOR INSTALLATION REQUIREMENTS
BEFORE ORDER CAN BE RELEASED. ORDER WILL NOT BE PROCESSED UNTIL VERIFIED
Standard-non-
waterproof sheet metal
cover
or