Prefabricated Chimney Serving an Appliance (PCSA) Level 1 and Level 2 checklist was created using NFPA 211 Chapter 15 and the Annex.

Its purpose is to help a sweep complete Levels 1 and 2 with additional questions to help gather as much information as possible.

This form is six pages long, so it's formatted to Legal-sized paper to print it if needed, but you can also use it on a mobile device or iPad.

Instructions for download:

When you buy this form, you will download a disclaimer we need everyone to read and sign before we send you the actual form, we are working towards an e-signature at checkout but we're not there yet.

Upon receiving the signed disclaimer, we will email your purchase. If you are purchasing more than one form at a time, you only need to fill out the disclaimer once.

A disclaimer will need to be signed for every purchase when forms are bought at different times.

The purchased PDF(s) can be copied onto other computers or devices in your business once downloaded.

FYI's:

IF you would like to edit this PDF, we suggest getting an Adobe DC account.

If you use a Service software like Smart Service/iFleet, you will need to buy the forms that say 'for Smart service, etc.' This is due to the formatting that is required.

These are standard fillable forms, so any software you’re using that can upload a PDF should be able to load these. Also, any device or app that can read or open a PDF should be able to use these.