Installation Data Sheet. Enviro Meridian, MERIDIAN 50-830

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Installation Data Sheet

The following information must be recorded by the installer for warranty purposes and future reference.

NAME OF OWNER: NAME OF DEALER:

_________________________________________

ADDRESS:

_________________________________________

_________________________________________

_________________________________________

PHONE:___________________________________

_________________________________________

ADDRESS:

_________________________________________

_________________________________________

_________________________________________

PHONE:___________________________________

MODEL:___________________________________

SERIAL NUMBER:___________________________

DATE OF PURCHASE: _____________ (dd/mm/yyyy)

DATE OF INSTALLATION:___________ (dd/mm/yyyy)

MAGNEHELIC AT INSTALL:___________________

INSTALLER’S SIGNATURE:

_________________________________________

NAME OF INSTALLER:

_________________________________________

ADDRESS:

_________________________________________

_________________________________________

_________________________________________

PHONE:___________________________________

MANUFACTURED BY:

SHERWOOD INDUSTRIES LTD.

6782 OLDFIELD RD. SAANICHTON, BC, CANADA V8M 2A3 www.envirofire.biz

December 6, 2004

C-10774