Wayne HSG400 - Page 5

5
INSTALLATION LOG
BURNER MODEL:
SPECIFICATION
NUMBER:
FUEL (NATURAL OR
LP):
GAS ORIFICE SIZE:
INLET GAS
PRESSURE
(in. w.c.):
CO
2
(%):
O
2
(%):
CO (PPM):
INSTALLER’S NAME:
CONTRACTOR NAME:
CONTRACTOR
ADDRESS:
CONTRACTOR PHONE
NUMBER:
CONTRACTOR
LICENSE #:
DATE OF INSTALLATION:
COMMENTS ABOUT INSTALLATION/START UP:
THESE INSTRUCTIONS SHOULD BE AFFIXED TO THE BURNER OR ADJACENT
TO THE HEATING APPLIANCE.
BURNER/APPLIANCE SERVICE LOG
SERVICE DATE
TECHNICIAN
COMPANY
/ ADDRESS
CONTRACTOR
LICENSE #
WORK PERFORMED
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