HomeMy WebLinkAbout2003, 05-07 Notice of Hazardous ConditionsiuVISTA
NOTICE OF HAZARDOUS CONDITIONS
Utilities
Customer Name deeddi 70
Address • //3e3
TYPE OF
NOTIFICATION:
Phone Number
S-0308 (06-01)
7z• 0 z�p
City L/�G) a0CV — q471 e
5-7CQ
❑ HAZARD The conditions 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 10 62._c
equipment until it has been repaired.
Equipment Type: AS +rte be,- Location4.1:7Z'L) I C ca.' ie) et-C(4,_
CONDITIONS Apparent cracked or restricted heat exchanger
FOUND:
,Apparent
appliance connector
❑ Damaged or disconnected vent
❑ Gas leak at gas equipment
❑ A gas leak in your house piping in the amount of CFH
with all known appliances off
❑ Insufficient combustion/ventilation air
LI Other
7-1
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Meter Left CIO , Off On Meter Number
I have read, understood and acknowledge receipt of this notice.
_/
Customer Signature �""
S(
Service Representative
Meter Read
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❑ Owner ,O®Tenant ❑ Agent
❑ Refused to Sign
Date 7- o3 Time
White Copy— Custoiner YeI/ow Copy—Attach to Service Order Pink Copy— Authority Having Jurisdiction
Hard Copy—Appliance
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