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Distributeur où l’appareil a été acheté
Nom :
Adresse :
Numéro de téléphone :
Informations essentielles – Cette section DOIT être remplie:
Date d’installation :
Description du modèle :
Numéro de série :
Technicien installateur:
Nom de la société :
Adresse :
Numéro de téléphone :
Vérifications de mise en service - à remplir et signer:
Le conduit de fumée est approprié à cet appareil OUI NO
Le conduit a été ramoné et le test de vacuité a été effectué. OUI NO
Le test de fumée de l’appareil installé a été effectué OUI NO
Le test d’étanchéité du corps de chauffe a été effectué OUI NO
L’utilisation de l’appareil et le fonctionnement des
commandes ont été expliqués OUI NO
Les distances aux matériaux combustibles ont été vérifiées OUI NO
Le manuel d’instructions a été remis au client OUI NO
Le détecteur-avertisseur de CO a été installé
(recommandé) OUI NO
Lecture du tirage du conduit (Pa) CHAUD FROID
Signature: ............................................................................ Nom en majuscules: .....................................................
Pour faciliter les démarches de dédommagement sous garantie, veuillez fournir les informations suivantes :-
LISTE DES VÉRIFICATIONS DE MISE EN SERVICE
FR
4


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