HomeMy WebLinkAboutBuilding Field Test & Inspection Report 1985-2-6
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Springfield Utility Board
I NSPECTION FORM
ACCOUNT NO.OO 1- 0 I J...J L\ 0 AUDIT DATE
INSPECTION DAT6 )P\10 \ "1 TIME ;:}2D INSPECTION NO
REINSPECTION DATE ~e..\o I~ TIME~3D INSPECTION NO.
CUSTOMER'S NAME \-iBj?1l )(\\ NLtR.phLJ OWNER'S NAME
ADDRESS-H9B ~ DCH..:::,l1 ADDRESS
ZIP CODE Cf7'-l76 STATE
HOME '-1.) i I ^'::lD. ^ BUSINESS ,
PHONE ~ - (^-')_~ PHONE OWNERS PHONF
(NO. OF UNITS)
BUILDING TYPE
1
2-
_C:.Pr t'{\ ~
INSPECTED BY 2.D
INSPECTE D BY .2n
ZIP CODE
LOW INCOME
ALL MEASURES COMPLETED
CHECK TO OIC
KWH SAVED
PREVIOUS INSTALLED MEASURES
PREVIOUS REIM. TO CUSTOMER
IAQ SURT"T^'"
l
~.STORM WI NDOWS
\ ~,PATIO/FRENCH DOORS
? WALL I NSULATI ON
~'CEILING INSULATION II R-ADDED
I. ~LOORINSULATION
\j WEATHERSTRI P
DOORS I WI N DOWS
CAULKING
MEASURE
AREA
KWH
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SEAL DUCTS
DUCT WRAP
CLOCK THERMOSTATE
OTHER
TOTAL
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COMMENTS: /AJ.r~L,IT'tJ~.J
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r TOTAL REIMBURSEMENT
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INSTALLED MEASURES APPROVED
FOR REIMBURSEMENT BY:
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DATE: 2.-b-~S-'
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