38745-4-0319
Page 3
ATTENTION INSTALLER:
Follow This Standard Work Checklist
This standard work checklist is to be used by the installer in conjunction with, not instead of, the instruction manual.
Customer: _____________________________________
Lot/Address: ___________________________________
_______________________________________________
Model: ________________________________________
Serial # ________________________________________
Date Installed: _________________________________
Fireplace Location: _____________________________
Installer: ______________________________________
Dealer Phone #: ________________________________
______________________________________________
Empire recommends the following:
•
Photograph the installation and copying this checklist for your file.
•
Keep this checklist visible on the fireplace until the installation is complete.
Comments:
Further description of the issues, who is responsible (Installer/Builder/other, etc) and corrective action needed:
___________________________________________________________________________________________________________
Comments communicated to party responsible
_____________________
by
_____________________
on
______________________
DvCT(36,40)CbP95(N,P)-1
FIREPLACE INSTALLATION
COMMENTS
Verified clearances to combustibles. (pg. 12) ......................................................................
o
____________________
Fireplace is leveled and secured. ........................................................................................
o
____________________
vENTING/CHIMNEY/PowerFlow™ HEAT DISTRIbUTION
Venting configuration complies to vent diagrams. (pg. 27) ..................................................
o
____________________
Venting installed, locked, secured in place with correct clearance. .....................................
o
____________________
Firestops installed. ...............................................................................................................
o
____________________
exterior wall/roof flashing installed and sealed. ...................................................................
o
____________________
Terminations installed and sealed. (pgs. 28-31) ..................................................................
o
____________________
Light unit and test venting before enclosing the fireplace. ...................................................
o
____________________
ELECTRICAL (pgs. 16-17)
Unswitched power (110-120 VAC) provided to the appliance. ............................................
o
____________________
GAS (pg. 15)
Proper appliance for fuel type. .............................................................................................
o
____________________
Was a conversion performed? ..............................................................................................
o
Yes
o
No
Leak check performed and inlet pressure verified ................................................................
o
____________________
FINISHING (pg. 19)
Non-combustible board used as required.............................................................................
o
____________________
Verified all clearances meet installation manual requirements. ...........................................
o
____________________
mantels and wall projections comply with installation manual requirements. ......................
o
____________________
Granite or Clean Face finishing complete and complies with clearance
requirements in installation manual. ....................................................................................
o
____________________
Barrier screen for glass properly installed. ..........................................................................
o
____________________
FIREPLACE SETUP
All packaging and protective materials removed (inside & outside of appliance) . ...............
o
____________________
media installed correctly. .....................................................................................................
o
____________________
Firebox glass assembly cleaned, installed, and secured. ...................................................
o
____________________
Accessories installed properly. ............................................................................................
o
____________________
manual envelope and all of its contents are removed from inside/outside the
appliance and given to party responsible for use and operation. ........................................
o
____________________
Started Appliance and verified no gas leaks exist. ..............................................................
o
____________________