2008, 07-08 Avista Notice of Hazardous ConditionswilISTA'
Utilities
NOTICE OF HAZARDOUS CONDITIONS
S-0308 (11-05)
Customer Name tdi 44..rxtr'r 4&II< Phone Number 27. 6223
Address /7I �:. 3 C. Li< ' . City ,..57.20 f L
HAZARD The conditioris noted below constitute an immediate hazard and may result in property damage, personal injury, or loss
of life. The equipment has been disconnected or left inoperable, and shall not be turned back on until such repairs have been completed
by a qualified HVAC dealer, contractor, or service agency, and the equipment has been brought up to current safety standards. Do not
attempt to use this equipment until it h been repaired.
TYPE OF
NOTIFICATION:
Equipment Type:
CONDITIONS
FOUND:
ce6
❑ Apparent cracked or restricted heat exchanger
❑ Damaged appliance connector
❑ Damaged or disconnected vent
❑ Gas leak at gas equipment
Location
❑ A gas leak in your house piping in the amount of CFH
with all known appliances off
❑ Insufficient combustion /ventilation air
❑ Other
Meter Left ❑ Off ❑ On Meter Number
I have read, understood and cknowledge receipt of this notice.
Customer Signature 1�, /11,4 ""`
Service ,Representativ
Meter Read
Jii' Owner ❑ Tenant ❑ Agent
/II-6V
WMS #
❑ Refused to Sign
Date 7. 8 -0 f7 Time
iteCopy— Customer Yellow Copy— Attach to Service Order Pink Copy— Authority Having Jurisdiction
Hard Copy — Appliance
m/pm