<p> CONTRACTOR CHECKLIST Revised 08/01/2005 Job# ______Contractor Name ______Client Name ______Address ______Phone # ______City ______Please complete where applicable Natural Gas Furnaces ______Propane ______Gas Water Heater ___ Elec. Water Heater______Retrofit ______Replacement ______Retrofit_____Replacement Limit off on high limit? Yes No CO Reading ______PPM Fan on temp.______Degrees or Timed Draft Reading ______IWC Fan off temp. ______Degrees or Timed Copper Gas lines replaced ? Yes No NA CO Reading ______PPM Temperature in Flue ______Degrees Manual Shutoff valve present? Yes No Temperature Rise Condition of venting ______Manufacturer Spec. ______Degrees Does vent/chimney draft - See Table* ______IWC Measured Spec. ______Degrees Condition of burners ______Replaced Thermocouple? Yes No NA Conditions of Ducts ______Burner door/panel in place? Yes No All rooms receiving heat ? Yes No T / P Valve operational ? Yes No Adequate return air present ? Yes No T / P Valve discharge pipe properly installed ? Yes No Draft Pressure - See Table* ______IWC Drip Leg / Sediment trap present ? Yes No Condition of vent?______Flue liner installed w/cap ? Yes No NA Mobile Homes Class B vent installed? Yes No NA Flue Collar installed? Yes No Temp in Flue ______Degrees Supply ducts attached to floor ? Yes No All heated rooms receiving heat ? Yes No Leaking gas lines replaced ? Yes No NA Defective floor registers replaced ? Yes No Copper gas lines replaced ? Yes No NA Sealed combustion system ? Yes No Uncoated Brass Flex connectors replaced ? Yes No NA Uncoated Brass Flex connectors replaced? Yes No NA Manual Gas shutoff valve present ? Yes No Gas Stoves Elec. shutoff switch present ? Yes No Manual Gas Shutoff valves present ? Yes No Drip Leg / Sediment trap present ? Yes No Uncoated Brass Flex connectors replaced? Yes No NA Rated Input ______BTU Gas Dryer Clocked Gas Input ______BTU Manual Gas Shutoff valves present? Yes No Fuel Pressure ______I W C Uncoated Brass Flex connectors replaced? Yes No NA Client Document Thermostat operational ? Yes No Sizing chart completed ? Yes No Heat Anticipator Setting ______PMI left with client ? Yes No Filter left with client? Yes No 90+ Furnaces Contractor guarantee with client? Yes No 2 pipe systems installed? Yes No NOTE: Incomplete service entries or omissions of Contractor signature and date of service may If No, Please state reason: delay payment for service rendered. ______RETROFIT INSTALLED ______IID / Vent Damper ? Yes No Technician’s Signature Set Back Thermostat ? Yes No GENERAL OBSERVATIONS ______Condition of Flame ______Wiring ______Contractor’s Signature Condition of Combustion Chamber ______Date ______Filter Replaced ? Yes No * Refer to back of Checklist for minimum draft readings at various outdoor temperatures. CONTRACTOR CHECKLIST</p><p>OIL HEAT NOTES:</p><p>Condition of Electrodes ______Stack control drop out time ______Draft over flame ?______Yes No ______Draft in Flue ? ______Yes No ______Chimney needs cleaned? ______Yes No ______Smoke test reading ______Oil Nozzle Size ______Oil Nozzle replaced ______Yes No ______Change Oil Filter ______Yes No ______Barometric Damper operational?______Yes No ______Class A vent installed?______Yes No ______Condition of Fuel Lines ______Condition of Chimney ______CO Reading ______PPM ______Efficiency ______%</p><p>ELECTRIC HEAT * Minimum draft readings at various outdoor temperature Condition of fuses ______Outdoor Temperature Draft Temperature Condition of Elements & Links ______below 21F -5-0 Pa (0.020” w.c.) Amp Draw ______21F to 40F -4.0 Pa (0.016” w.c.) Voltage ______41F to 60F -3.0 Pa (0.012” w.c.) Temp Rise - Manufacture ______61F to 80F -1.0 Pa (0.008” w.c.) Measured ______above 80F -1.0 Pa (0.004” w.c.)</p><p>Boilers</p><p>Fill Valve operational ? ______Yes No NA Expansion tank drained ?______Yes No NA System bled ?______Yes No NA NOTE: System pressure ______PSI Incomplete service entries or omissions of Low water cutoff operational?______Yes No NA Contractor signature and date of service may Low water cutoff cleaned ?______Yes No NA delay payment for services rendered. Pressure/Temp Valve operational?_____ Yes No NA Water sight glass visible & cleaned ?___ Yes No NA Circulator on Temp. ______Degrees ______Circulator off Temp. ______Degrees Technician’s Signature Pigtail removed & cleaned (steam) ? Yes No ______Condition of piping ______Contractor’s Signature All heated rooms receiving heat? Yes No DATE ______</p><p>Word Pro/h:eo/IHWAP/Forms/Furnace-Contractor- Checklist-08-01.doc</p>