HomeMy WebLinkAboutSpecial Inspection Miscellaneous 1984-11-15
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Springfield Utility Board
I NSPECTION FORM
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ACCOUNT No?--.lllj - ~::<-l! ,() AUDIT DATE
INSPECTION DAT!" \ R... \ 2C> TIME..lL-INSPECTION NO.
REINSPECT ION DAT~ TIME
CUSTOMER'S NAME Dr:i-e.l{ \ t:R\C~
ADDRESS,~'l '.4~ ND\JQ
ZIP CODE
~~~~E..2:J l-LJ (,49
LOW INCOME-!J.I)
BUSINESS
PHONE
(NO. OF UNITS)
BUILDING TYPE
KWH SAVED
PREVIOUS INSTALLED MEASURES
2-D
INSPECTED BY
INSPECTION NO
OWNER'S NAME .<::"A-'rf)..Q.
INSPECTED BY
ADDRESS
STATE
OWN ER'S PHONF
ALL MEASURES COMPLETED
ZIP COD~
CHECK TO O/C
PREVIOUS REIM. TO CUSTOMER
lAC SUBTOTAL
AREA
I MEASURE
I)~~~RM WINDOWS
I PATIO/FRENCH DOORS
I
I
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I
I
I SEAL DUCTS
11 DUCT WRAP
CLOCK THERMOSTATE
I OTHE R
Ii TOTAL
I CO.."",
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!~?..t.
I
WALL INSULATION
II R-ADDEO
CEILING INSULATION
FLOOR INSULATION
WEATHERSTRI P
DOORS / WI N DOWS
CAU LK I NG
INSTALLED MEASURES APPROVED
FOR REIMBURSEMENT BY:
KWH
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COST
RE I MBURSEMENT
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~ TOTAL I
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