HomeMy WebLinkAboutBuilding Miscellaneous 1984-10-12
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Springfield Utility Board
ACCOUNT Na.2(rh -01 (n/ P,
INSPECTION DAHJf.:\l\) It,
I NSPECTION FORM
AUDIT DATE 10 -1:).8<J
1'\"::'>r"I I
TIMFd., J INSPECTION NO INSPECTED BY
:20
REINSPECT ION OAT" TIME INSPECTION NO INSPECTED BY
CUSTOMER'S NAMElJA\)I['. S~l\de&lk) OWNERS NAME _"0f4rnR
ADDRESS1!:!.J..CL1 J,), ~ UI (\lciL+ ADDRESS
ZIP CODFq,J..rij STATE ZIP CODE
HOME 7JJ '7 - I'J L BUSINESS
PHONE_~_- I ,L}. PHONE OWNERS PHONF
(NO. OF UNITS)
LOW INCOME BUILDING TYPE ALL MEASURES COMPLETED CHECK TO O/C
KWH SAVED
PREVIOUS INSTALLED MEASURES
PREVIOUS REIM. TO CUSTOMER
IAO SUETOTAL
MEASURE AREA
STORM WINDOWS /4P~
PATIO/FRENCH DOORS /.j ("J ;6
WALL INSULATION
II R-ADDED
CEILING INSULATION
I FLOOR INSULATION
I WEATHERSTRI P
DOORS / WI N OOWS
I CAU LK I NG
I SEAL DUCTS
I DUCT WRAP
I C LOC K THERMOSTATE
I OTHER
,I TOTAL
KWH
COST
R E. M BURSEMENT
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I
I
I
I
I
I
I
I
II TOTAL RE I M BURSEMENT
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0/
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INSTALLED MEASURES APPROVED
FOR REIMBURSEMENT BY:
DATE: