PV500-27A 07/04
5
MAINTENANCE & SAFETY INSPECTION REPORT
DATE
BURNER
INSPECTION
COMBUSTION
ANALYSIS
TANK
INSPECTION
TANK FLUSH
& CLEANOUT
TANK FITTING
INSPECTION
VENT
INSPECTION
THERMOSTAT
INSPECTION
GAS TRAIN
LEAK TEST
Recommended
Inspection
Intervals
YEARLY
6 MONTHS
6 MONTHS 3
MONTHS 6
MONTHS YEARLY YEARLY YEARLY
TABLE 27A-1
NOTE: Burner Inspection and Combustion Analysis should be done by a factory authorized service person.