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COMPANY NAME TELEPHONE NUMBER DATE : START TIME/KMS (DEPART) : ______________ RETURN TIME/KMS (RETURN) : ______________ TIME BUILDER SITE LOT # MODEL Start Finish SANITIZATION RE-CLEAN "X" P.O./COMP. # (For Office Use) Extras: -- Air Filter -- Scented Filter NAME : NOTES OR EXTRAS CHECKLIST Furnace blower & air filter cleaned All heat registers cleaned All cold air return intakes cleaned All dirt/debris removed from ducts is cleaned from floors Sticker is placed on furnace Furnace blower & air filter cleaned √ YES NO YES NO All heat registers cleaned All cold air return intakes cleaned All dirt/debris removed from ducts is cleaned from floors Sticker is placed on furnace Furnace blower & air filter cleaned YES NO All heat registers cleaned All cold air return intakes cleaned All dirt/debris removed from ducts is cleaned from floors Sticker is placed on furnace Furnace blower & air filter cleaned YES NO All heat registers cleaned All cold air return intakes cleaned All dirt/debris removed from ducts is cleaned from floors Sticker is placed on furnace Furnace blower & air filter cleaned YES NO All heat registers cleaned All cold air return intakes cleaned All dirt/debris removed from ducts is cleaned from floors Sticker is placed on furnace Furnace blower & air filter cleaned YES NO All heat registers cleaned All cold air return intakes cleaned All dirt/debris removed from ducts is cleaned from floors Sticker is placed on furnace Furnace blower & air filter cleaned YES NO All heat registers cleaned All cold air return intakes cleaned All dirt/debris removed from ducts is cleaned from floors Sticker is placed on furnace Furnace blower & air filter cleaned YES NO All heat registers cleaned All cold air return intakes cleaned All dirt/debris removed from ducts is cleaned from floors Sticker is placed on furnace