HomeMy WebLinkAboutPermit Field Test & Inspection Report 1985-01-168gc;-t+
Sp rin gfield (Itility B o ar d
ACCOUNT NO
INSPECTION FORM
98q e AUDIT DATE
-
qs#r \arrr lCION DAT T IME
T IME
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3R?rNSPEclo* oor. hp E9
INSPECTION NO.
INSPECTION NO.
INSPECTED BY ZO2TNSPEcTE o ay ZO
cusrouen's NAM OWNERS NAME
ADDRESs riLl f, l,;o I { ADDRESS
ZIP CODE STATE ZIP CODE
BUS I N ESS
OWNERS PHONE
ALL MEASURES
PHONE
COMPLETED
-
PREVIOUS REIM.
E335asr-aaeL
Low rNcoMe AJo ( NO. OF UN ITS
EUILDING TYP E-) o/c
L
MENT
u
1/,oo
KWH SAVED
PREVIOUS INSTALLED MEASURES
MEASURE AREA
STORM WINDOWS
PATIO/ FRENCH DOORS
WALL INSULATION
CEILING INSULATION
R. ADOEO
TFLOOR INSULATTON
DOORS wrN Dows
WEATHERSTRI P
CAU LK I NG
SEAL DUCTS
DUCT WRAP
CLOCK THERMOSTATE
OTHER
TOTA L
TOTAL REI MBURSEMENT
-2COMMENTS:L
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INSTALLED MEASURES APPROVED
FOR REIMBURSEMENT BY DAT E o{YJ"* D',/-,J