43
Date Purchased:
Purchaser/Dealer:
Installer:
Fireplace S/N on product ID tag:
Date Installed:
FUEL:
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◯
Natural Gas
◯
◯
L.P. Propane
Inlet Pressure Measured After Installation:
In. W.C.
Manifold Pressure Measured After Installation:
High Fire:
In. W.C.
Low Fire:
In. W.C.
VENTING:
Please Verify The Brand And Model Of Venting Used:
Vent Termination (Cap):
◯
◯
Horizontal
◯
◯
Vertical
◯
◯
Snorkel
Vent Cap Model No:
CONFIGURATION:
Vent Configuration Sketch Required Below:
Total Horizontal Run:
Feet/Inches
Total Vertical Run:
Feet/Inches
Quantity 90° Elbows:
Quantity 45° Elbows:
ALTITUDE:
Feet Above Sea Level
Was Stove Derated?
◯
◯
Yes
◯
◯
No
If Yes To What Orifice Size?
Unusual Structure Near Vent?
◯
◯
Inside Corner
◯
◯
Trees/Shrubs
◯
◯
Other
Termination:
(Please Describe)
Prevalent Wind Conditions?
Other Installation Notes:
INSTALLATION RECORD
The installer should complete the form below that describes the details of the installation. Having this
written record of installation information available will greatly expedite trouble-shooting should any problem
arise with your fireplace. The installer should keep a duplicate of this form for their records. Accurate
completion of this form is required for warranty coverage and for any technical support by
Woodbridge Fireplace Inc.
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