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KEURING VAN DE WERKEN
IN DRUKLETTERS INVULLEN AUB
DE KOPER
NAAM .....................................................................................................
VOORNAAM ..........................................................................................
ADRES VAN DE WERKEN .........................................................................
POSTCODE .............................................................................................
GEMEENTE ..............................................................................................
LAND ......................................................................................................
DE INSTALLATEUR
MAATSCHAPPIJ ......................................................................................
UW STÛV GASHAARD
MODEL ..................................................................................................
SERIENUMMER .......................................................................................
DATUM VAN DE INSTALLATIE ...............................................................
KENMERKEN VAN DE LEIDING
HOOGTE VAN DE LEIDING IN M ............................................................
DIAMETER VAN DE LEIDING Ø100/150 Ø130/200
TYPE UITLOOP MUUR VERTICAAL
MERK VAN DE LEIDING ..........................................................................
CONTROLE VAN DE AFSTELLING VAN HET TOESTEL
HET GEBRUIKTE GASTYPE IN HET TOESTEL KOMT OVEREEN MET DE FABRIEKSINSTELLINGEN
GEBRUIKT GASTYPE ...............................................................................
AANVOERDRUK (STATISCH) ..................................................................
AANVOERDRUK (DYNAMISCH) .............................................................
DE DECORATIEKIT MET HOUTBLOKKEN OF KEIEN WERD GEPLAATST ZOALS AFGEBEELD
IN DE INSTALLATIEHANDLEIDING
OPMERKINGEN ......................................................................................
.................................................................................................................
.................................................................................................................
VEILIGHEIDSVOORSCHRIFTEN
Het gebruik van dit toestel dient conform de aanbevelingen van de installateur en de voorschriften van de fabrikant te
zijn die vermeld worden in de installatiehandleiding die met de factuur en dit proces-verbaal van ontvangst overhandigd
wordt.
Het aansluiten van het toestel op het gasdistributienet werd uitgevoerd door een gekwalificeerd vakman en volgens de
geldende nationale en lokale voorschriften
DE INSTALLATEUR (naam voluit geschreven en handtekening)
DE KLANT (naam voluit geschreven en handtekening)) ............................
gebruiks- en onderhoudshandleiding van het toestel overhandigd aan de klant
54


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