Werkingscontrole uitgevoerd:ja nee Test - verbranding uitgevoerd ja nee
Alleen bij SENSO M H2O / PIKO H2O
Verwarmingsinstallatie ontlucht
Bedrijfsdruk gecontroleerd
ja nee
ja nee
Voer de temperatuur tussen het gebruik en de retourverhoging in:
Retourtemperatuur in °C
Voorlooptemperatuur in °C
De gebruiker van de houtkachel is geïnstrueerd
over de bediening en de montage- en bedieningshandleiding is
overhandigd
Handtekeningen
Monteur / Gebruiker
Jaarlijks uitgevoerde onderhoudswerkzaamheden
Type werkzaamheden
Naam
Datum
Handtekening
LET OP: zorgvuldig bewaren!
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