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Company Name
Division
Name
Address
TEL
FAX
E-Mail
Application to install Thermostat
Purpose of use

Type

Operation

Property

Operation Temp（OPEN）
Operation Temp（CLOSE）
Electrical Rating

Actual Voltage
Actual Amperage
Load Type

Ambient Temp（Normally）
Ambient Temp（Abnormally）
Expected Quantity
Approval Request

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