© 2021 United States Stove Company
3
INSTALLATION CHECKLIST
Your Gas Stove should be installed by a qualified installer only. An NFI qualified Installer can be found at
www.nficertified.org/public/find-an-nfi-pro/
CUSTOMER SERVICE
1-800-750-2723 ext 5050
Text to 423-301-5624
Email to: [email protected]
COMMISSIONING CHECKLIST
This Checklist is to be completed in full by the qualified person who installs this unit. Keep this page for
future reference.
Failure to install and commission according to the manufacturer’s instructions and complete this checklist
will invalidate the warranty.
Please Print
Customer Name:
Telephone Number:
Address:
Model:
Serial Number:
Installation Company Name:
Phone Number:
Installation Technician’s Name:
License Number:
DESCRIPTION OF WORK
Location of installed appliance: _________________________________________________________________________
Venting System: New Venting System Yes No If yes, Brand __________________________________
If no, Date of inspection of existing venting system: ______________________________________________________
COMMISSIONING
Confirm Hearth Pad Installation as per Installation Instructions
..............................................................................................
Confirm proper placement of internal parts
...........................................................................................................................................
Check soundness of door gasket and door seals .................................................................................................................................
Confirm clearances to combustibles as per installation instructions in this manual
.................................................
Check the operations of the air controls ....................................................................................................................................................
Confirm the venting system is secure and sealed
...............................................................................................................................
Confirm the stove starts and operates properly
....................................................................................................................................
Check to ensure a CO alarm is installed as per local building codes and is functional .............................................
Explain the safe operation, proper fuel usage, cleaning, and routine maintenance requirements .................
Declaration of Completion: As the qualified person responsible for the work described above, I confirm that
the appliance as associated work has been installed as per manufacturer’s instructions and following any
applicable building and installation codes.
Signed: ___________________________________Print Name: ______________________________ Date: _____________
Home Owner: RETAIN THIS INFORMATION FOR FUTURE REFERENCE
