Prefabricated Chimney Serving an Appliance (PCSA) - Solid Fuel Level 1 and Level 2 checklist was created using NFPA 211 Chapter 15, and the Annex. Its purpose is to help a chimney technician perform a complete Level 1 and 2 with additional questions to help you gather as much information as possible.

It is focused on appliances that use Solid fuels such as Wood or Coal.

If you're dealing with Liquid fuels like natural gas, you'll want to use the PCSA - Liquid Fuel form.

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

The short form is a shortened version of our long forms. You still gather all the necessary information about the Chimney but without the 'extra detail' questions.

This form is two pages long, so it's formatted to Legal-sized paper to print 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 sending 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 buying at different times.

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