PlumbingStore.com - Eemax Acknowledgement for Three Phase Series 6 & 12 Tankless Water Heaters

Eemax Acknowledgement for "Three Phase" Models

Please Print, Sign, Date, and Fax to:
Toll Free 866-744-0521

Please note that these units are custom made to order.
This order is NON-CANCELLABLE and the item(s) are NON-REFUNDABLE, NON-RETURNABLE.
By signing and dating below, you agree and accept these terms and conditions.

MODEL:_________________ KW:____ VOLTS:____ AMPS PER PHASE:____

Note: 208/120V 3-Phase
Note: 240V 3-Phase
Require Delta Connection

Delta Configuration
Requires: 3 Lives, 1 Ground

Please Check a Box Above to Specify the Voltage Requirements

Note: 380-220V 3-Phase
Note: 480/277V 3-Phase
Require Star Connection

Star Configuration
Requires: 3 Lives, 1 Neutral, and 1 ground

UNDER NO CIRCUMSTANCES CAN THESE ELECTRICAL CONFIGURATIONS BE REVERSED

Print Your Name:_______________________________Order # (if applicable)_______________________

Signed and Accepted by:______________________________________Date:______________________
Email Address:______________________________________________Phone:_____________________

Note: If you're ordering a Series 6 or Series 12 tankless water heater,
you'll also need to print and fill out this form.

If you are going to mail this page (instead of faxing), please mail it to:

Mailing Address:
PlumbingSupply Group, LLC
Atten: 'your order number'
994 East 20th Street
Chico, CA 95928

"When do I fill out this form and why?"

If you are ordering a 3-phase Eemax heater, you will need to print and fill out this form, and then fax or mail it to us. Eemax manufactures the 3-phase units to order, so these heaters are not returnable. The manufacturer requires us to include this form with our shipment request. This provides them with verification ("proof") on-file that they manufactured and shipped the correct heater.