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ALL MEASURES COMPLETED .- CHECK FLAG ( O/C)
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Springfield Utility Board
ACCOUNT NO.
INSPECTION DATE
INSPECTION DATE
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CUSTOMER.S NAME
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NO. OF UNITSLow-rNcoME )': o BUILDING TYPE
INSPECTI ON FOR M
AUDIT NO.t AUDIT DATE t 3- r-1- g
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INSPECTION NO.
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INSPECTED BY
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ME A SURE AR EA COST IN CEN TIV E
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PATIO SLIDERS
WALL INSULATION
CEIL ING INSULATION
FLOOR INSULATION
DUCT INSULATION
IvIAJOR MEASURE
SUBTOTAL
WEATHERSTR I P
DOORS,/WINDOWS
CAULK ING
CLOCK -THERMOSTAT
INSULATED DOOR zqh 67 o
OTHER
OTHER
TOTAL
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TOTAL REIMEURSEMENT
MEASUR S APPROVEDINSTALLED
FO R REIMBURSEMENT BY,DATE
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KWH- SAVED
SEAL DUCTS
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