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2004, 05-11 Notice of Hazardous Conditions
Sidunsra Utilities NOTICE OF HAZARDOUS CONDITIONS Customer Name n Phone Number Address TYPE OF NOTIFICATION: Equipment Type CONDITIONS FOUND: 3-0308 (08-011 /'/6,11„1 /PInriTC-OWJGTk / city<•e-f-029A)s . (i,4 -i/ -EY ,f / ©,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 m thi e.ui rment until it has been re. aired. .t• t p/A7t FttA)1, t' Apparent cracked or restricted heat exchanger U Damaged appliance connector ❑ Damaged or disconnected vent O Gas leak at gas equipment Lacatiom MAI -1.43 E7 (. /L//IG74crw, i t J1 O A gas leak in your house piping in,the amount of � CFH with all known appliances off V 1 O Insufficient combustion/ventilation air O Other r� Ex - .. ✓ (.) .t /11...✓' - _ tit A n _ A^ /U7 Ir6YKi `) 1C/L./1'/////U/U Lfinal v /vfW/urr/.n.- /1 r -7;, n -nrr- ir- _.v I V I jr per /GL Y/ncC • Lina,-)/ i.�1 r Meter Left '0' Off 0 On Meter Number Meter Read `r V- v ( (i / have read, understood and acknowledge receipt of this notice ❑ Owner 0 Tenant 0 Agent Customer Signature I �` 'l-- ;x,_.^^"" 0 Refused to Sign 1 Service Representative +—+IlrC ` -r e atiV 5 1 tr Date OS// Time( '5 Whne Copy —Customer Yellow Copy— Attach to Service Order Pink Copy— Authority Haying Jurisdiction Hard Copy —Appliance 0 am/pm'