Pulte Group Temp Heat Order Form

Temp Heat Order Form

Please fill this form out, tap on name to expand form.

Heater Scenario

1. No Natural Gas No Power

2. No Natural Gas Has Power

3. Has Natural Gas Has Power

4. Has Natural Gas No Power

5. Converted Furnace Has Power

Has Natural Gas?

No Yes

Has Electricity?

No Yes

Converted Furnace?

No Yes

LP Generator?

No Yes

New Order

Heater(s)

Propane Natural Gas
Converted Furnace
100# cylinders

Requested Install Date

*Completed within two business days of submitted form.

Heater # & Location: Basement

Is the basement flooded?

No Yes

Heater # & Location: Garage

500 gallon tank location

Special Request

Hose Number

Hose Length(s), if not 100's

Basements must have steps to bottom and less that 6" of water.

Tank Refill

Current Tank Percentage

Requested Fill Percentage

Comments

Relocate Equipment

Requested Move Date

*Completed within two business days of submitted form.

Existing Location - Subdivision

Existing Lot

Desired Location - Subdivision

Desired Lot

Current Tank Percentage

Requested Fill Percentage after move

Comments

Remove Equipment

LP Nat Gas Tanks
Hoses Hangers

Requested Removal Date

Current Tank Percentage

*All equipment will be removed from site including tank, heaters and hose*

Special Instructions

Are hoses frozen in mud or buried?

No Yes