34
6720819898 C 11/2017
COMMISSIONING CHECKLIST
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Address:
Model:
Serial number
Installing Company Name:
Installing Engineer’s Name:
State Chimney Designation:
Confirm Hearth Installation Is Correct
Bedroom Lounge Other: Sp
ec
ify_________________________
Chimney System: New Insulated Fa
cto
ry Made Chimney System Installed? Yes
No
himney: Twin Wall Flexible Liner (for Clas
tal
Commissioning
Confirm pro
pe
r placem
ent of internal parts
Chec
k soundness of d
s for this model
ontrols
C
onfi
rm all
flu
e pip
e co
Confirm th
e stove properly draught when
fi
red
Chec
k to insure a CO alarm is installed in the same room as the
ne maintenan
ce re
quirements
oved Document J Appendix E
Confi
rm you h
ave c
ommissioned and tested the applian
ce a
nd asso
c
As the
c
ompetent person responsible for the work des
c
ribed above, I
c
on
firm that
the applian
c
e and
asso
c
iated work has been installed in a
cc
ordan
c
e with and
c
ompl
proved Do
c
uments J,G & L as
applic
able.
Signed:__________________________________Print Name:________________________________Date:____________________
This form should be retained by the
c
ustomer for future referen
ce
.
Commissioning Checklist
This Commissioning Ch
ec
klist is to b
e c
ompleted in full by the
c
ompetent person who
c
ommissioned the stove as a means of
s and then handed to the
c
ustomer to keep for future refer-
ence.
Failure to install
and comm
ission
acc
ording to the manuf
act
urer
e Comm
issioning Checklist will
invalidate the warranty. This does
Please Print
not
affec
t the
c
ustomer’s statutory rights.
Содержание Worcester Greenstyle Hanbury 4
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