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MANUFACTURED BY:

SHERWOOD INDUSTRIES LTD.

6782 OLDFIELD RD. SAANICHTON, BC, CANADA V8M 2A3

www.envirore.biz

July 30, 2004

C-10804

NAME OF OWNER:

_________________________________________

ADDRESS:

_________________________________________

PHONE:___________________________________

NAME OF DEALER:

_________________________________________

ADDRESS:

_________________________________________

PHONE:___________________________________

MODEL:___________________________________

SERIAL NUMBER:___________________________

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

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

MAGNEHELIC AT INSTALL:___________________

INSTALLER’S SIGNATURE:

_________________________________________

Installation Data Sheet

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

NAME OF INSTALLER:

_________________________________________

ADDRESS:

_________________________________________

PHONE:___________________________________

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Enviro Empress Manuale Utente Pagina 13