Installation Data Sheet

The installer for warranty purposes and future reference must record the following information. Please keep this information for your records.

Name of Owner:

__________________________________________

Address:

__________________________________________

Phone:_____________________________________

•Model :___________________________________

•Serial Number: __________________

•Date of Purchase:

__________/________/________

•Date of Installation:

__________/________/________

•____ Natural Gas (Nat.), ____ Propane (LPG)

•Inlet Gas Supply Pressure: ________ in.w.c. If the orifices were changed by the installer.

•Front Burner Orifice # __________ ,

•Back Burner Orifice # __________ .

•Pilot Orifice # ________ or ______ in.Dia.

Installer's Signature: ________________________

Name of Dealer:

___________________________________________

Address:

___________________________________________

Phone: ___________________________________

Name of Installer:

___________________________________________

Address:

_________________________________________

___________________________________________

Phone :_____________________________________

E-MAIL ADDRESS ( envirofire@home.com )

WEB SITE ADDRESS (www.enviro-fire.com)

MANUFACTURED BY:

SHERWOOD INDUSTRIES, 6782 OLDFIELD ROAD., SAANICHTON, B.C., CANADA V8M 2A3

01/31/06