
38267-2-0619
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:
•
•
Comments:
___________________________________________________________________________________________________________
__________________________________________ ______________________
DVCT50CBP95(N,P)-1
FIREPLACE INSTALLATION COMMENTS
o____________________
o____________________
VENTING / CHIMNEY
o____________________
o____________________
o____________________
o____________________
o____________________
o____________________
ELECTRICAL (pgs. 16-17)
o____________________
GAS (pg. 15)
o____________________
oYes oNo
o____________________
FINISHING ( pg. 19)
o____________________
o____________________
o____________________
o____________________
o____________________
FIREPLACE SETUP
o____________________
o____________________
o____________________
o____________________
o____________________
o____________________