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HomeMy WebLinkAboutPermit Field Test & Inspection Report 1985-01-14INSPECTION FORM AUDIT DATE F4-ooL6 2 Springfield Utility B o ard -lACCOUNT NO- INSPECTION DAT REINSPECTION DATE HOM E PHON E d-\ 11tltg cl lNSpEcTtoN No. TIME-INSPECTION NO. INSPECTED BY cb INSPECTED BY cusroueR's NAME OWNERS NAME r(I+rnQ. ADDRESS ADD RE SS ZIP CODE STATE ZIP CODE BUSINE PHO NE SS OWNERS PHONE LOW INCOME ( NO. OF UNITS )auir-otNc TvP'E ALL MEASURES coMPLETED cHEcK ro o/c o5 c; o5 IAQ SUETOTALPREVIOUS REIM. TO CUSTOMERKWH SAVED PREVIOUS INSTALLED MEASURES REIMBURSEMENTCO STKWHAR EAMEASURE tLul,r,.riSTORM WINDOWS 3 E'l-t"ilPATIO/FRENCH DOORS WALL INSULATION R.AODEO. CEILING INSULATION " FLooR INSULATION DOo RS /wTNDOWS WEATHERSTRI P CAU LK I NG SEAL DUCTS DUCT WRAP CLOCK THERMOSTATE OTHER TOTAL t/COMMENTS u-s ) TOTAL REI MBURSEMENT '.e/9/t/o (L DAT EINSTALLED FOR MEASURES APPROVE REIMBURSEMENT BY: A5 t- oaar s n u-.nu I (