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Air Conditioning Myrtle Beach, Heating, Residential, Commercial HVAC | Tri-County Mechanical Inc. > Equipment Information Form

Equipment Information Form

Username
Date
MM slash DD slash YYYY
Customer Name
Work Order #
System Name #1
Age
Tons
Brand
Type
Htr Size
Condition
Model #
Serial #
Filter Size
System Name #2 (Optional)
Age
Tons
Brand
Type
Htr Size
Condition
Model #
Serial #
Filter Size
Notes
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Packaged Systems

Step 1 of 2

50%

First Name*
Last Name*
Phone
Email*
Please Provide a GPS Address so that We Will Know Where to Go!
Address
Street Address City ZIP / Postal Code

Please select the method by which you wish to be contacted.
- Phone
- Email
- Text
Preferred Appointment Time

: Hours

Minutes

AM/PM
Preferred Appointment Date
MM slash DD slash YYYY
Questions/Comments
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Hybrid / Dual Fuel Systems

Step 1 of 2

50%

First Name*
Last Name*
Phone
Email*
Please Provide a GPS Address so that We Will Know Where to Go!
Address
Street Address City ZIP / Postal Code

Please select the method by which you wish to be contacted.
- Phone
- Email
- Text
Preferred Appointment Time

: Hours

Minutes

AM/PM
Preferred Appointment Date
MM slash DD slash YYYY
Questions/Comments
CAPTCHA

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Air Conditioners with Gas Furnaces

Step 1 of 2

50%

First Name*
Last Name*
Phone
Email*
Please Provide a GPS Address so that We Will Know Where to Go!
Address
Street Address City ZIP / Postal Code

Please select the method by which you wish to be contacted.
- Phone
- Email
- Text
Preferred Appointment Time

: Hours

Minutes

AM/PM
Preferred Appointment Date
MM slash DD slash YYYY
Questions/Comments
CAPTCHA

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AC Replacement Commercial

Step 1 of 2

50%

First Name*
Last Name*
Phone
Email*
Please Provide a GPS Address so that We Will Know Where to Go!
Address
Street Address City ZIP / Postal Code

Please select the method by which you wish to be contacted.
- Phone
- Email
- Text
Preferred Appointment Time

: Hours

Minutes

AM/PM
Preferred Appointment Date
MM slash DD slash YYYY
Questions/Comments
CAPTCHA

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AC Repair Commercial

Step 1 of 2

50%

First Name*
Last Name*
Phone
Email*
Please Provide a GPS Address so that We Will Know Where to Go!
Address
Street Address City ZIP / Postal Code

Please select the method by which you wish to be contacted.*
- Phone
- Email
- Text
Preferred Appointment Time

: Hours

Minutes

AM/PM
Preferred Appointment Date
MM slash DD slash YYYY
Questions/Comments
CAPTCHA

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Split System – Ac / Heat Pump

Step 1 of 2

50%

First Name*
Last Name*
Phone
Email*
Please Provide a GPS Address so that We Will Know Where to Go!
Address
Street Address City ZIP / Postal Code

Please select the method by which you wish to be contacted.
- Phone
- Email
- Text
Preferred Appointment Time

: Hours

Minutes

AM/PM
Preferred Appointment Date
MM slash DD slash YYYY
Questions/Comments
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2nd Opinion

Step 1 of 2

50%

First Name*
Last Name*
Phone
Email*
Please Provide a GPS Address so that We Will Know Where to Go!
Address
Street Address City ZIP / Postal Code

Please select the method by which you wish to be contacted.*
- Phone
- Email
- Text
Preferred Appointment Time

: Hours

Minutes

AM/PM
Preferred Appointment Date
MM slash DD slash YYYY
Questions/Comments
CAPTCHA

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AC Replacement Residential

Step 1 of 2

50%

First Name*
Last Name*
Phone
Email*
Please Provide a GPS Address so that We Will Know Where to Go!
Address
Street Address City ZIP / Postal Code

Please select the method by which you wish to be contacted.
- Phone
- Email
- Text
Preferred Appointment Time

: Hours

Minutes

AM/PM
Preferred Appointment Date
MM slash DD slash YYYY
Questions/Comments
CAPTCHA

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AC Repair Residential

Step 1 of 2

50%

First Name*
Last Name*
Phone
Email*
Please Provide a GPS Address so that We Will Know Where to Go!
Address
Street Address City ZIP / Postal Code

Please select the method by which you wish to be contacted.
- Phone
- Email
- Text
Preferred Appointment Time

: Hours

Minutes

AM/PM
Preferred Appointment Date
MM slash DD slash YYYY
Questions/Comments
CAPTCHA

Δ