MS10-11C Issue 4d
41
Commissioning Form
Stove Purchased From:_____________________________________________________
Address:_________________________________________________________________
Telephone Inc area code:____________________________________________________
Installation Date:_____/_____/__________ Stove Name:_________________________
Product Serial Number:________________ Invoice Number:_______________________
Stove installed by:_________________________________________________________
Address:_________________________________________________________________
Telephone Inc area code:____________________________________________________
HETAS Registration Number:________________________________________________
Check-list
Yes No n/a
Heat load of house inc. DHW
kW
Heat requirement for room in which appliance is to be installed
kW
Nominal boiler output to water
kW
Nominal appliance output to room
kW
Hearth to building regs.
Chimney Flue Suitability
Ventilation (permanent)
Vent size
mm2
Discharge Pipe Route
Cold water main to boiler
Flow & return routing
Low loss header location
°C
Switched fused spur for pumps in boiler locale
Availability of open circuit rads/UFH zones
Output of above
kW
Designed system pressure
Designed system volume
l
Designed expansion volume
l
Designed expansion pre-charge
bar
Flue draught measurement
mbar
Placement and orientation of Back End Protection
Boiler Volume (wood burning)
l
Boiler Volume Existing gas/oil
l
Estimated system volume
l
Total system volume
l
Expansion volume
l
is this > 7% of total volume
Expansion correctly sited and connected
Smoke test of appliance and flue
System water treated with inhibitor
Thermal safety valve installed
Double check valve installed
No isolation from incoming main to Thermal Safety valve