Title Page

  • Project Number

  • Conducted on

  • Prepared by

  • Address

Make of Solid Fuel Heater

  • MAKE

  • MODEL

CONDITION REPORT

  • COMBUSTION HEATER/STOVE

  • Item Replaced?

  • FLUE INNER

  • Item Replaced?

  • COWL CHIMNEY COVER

  • Item Replaced?

  • ROOF FLASHING

  • Item Replaced?

  • FLUE OUTER

  • Item Replaced?

  • HEAT SHIELD

  • Item Replaced?

  • FIRE BOX

  • Item Replaced?

  • VENTS

  • Item Replaced?

  • BAFFLE

  • Item Replaced?

  • Item Replaced?

  • DOOR & GLASS

  • Item Replaced?

  • HINGES, HANDLES AND SEALS

  • Item Replaced?

  • HEAT TILES/BRICKS

  • Item Replaced?

  • FIRE BRICKS

  • Item Replaced?

  • BRICKS & MORTAR

  • Item Replaced?

Photos

  • ANY OTHER RELEVANT PHOTOS

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