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CHECK LIST iltt*Tit jegmpn pAp:rogotocitv,z A„,,, OW <br /> x'' AMOUNT` ' '1 in, . <br /> ! <br /> 0 WATER HEATER I [ I L TIAL L qe O Fz ,CIA <br /> ❑ELEMENTS _ .-:;-sa` 8 ,L4 1 <br /> ❑THERMOSTAT I ' .�� <br /> ❑RELIEF VALVE <br /> --- I ., �,.3i,i't +#g�«E rL.4.�.,:y, a 'd3s / v iE . <br /> ❑DiP TUBE s (360) 691 - 1 R /' <br /> DATE ORDERED <br /> ❑ELECTRICAL CONN. '-- --_-- # / / <br /> t# DATE SCHEDULED <br /> NAME <br /> ❑ GAS WATER HEATERS « f ,�I tg,' tlL / f <br /> ❑THERMOCOUPLE { �+TM ` ""°^"^^ <br /> BURNER STREET I ^s 'k} PHONE <br /> ❑CONTROL(GAS) kj,t'I 'r . <br /> ❑FLUE PIPEzIP WK.PHONE <br /> 0 RELIEF VALVE CITY t STATE <br /> ttt <br /> 0 TOILET MAKE MODEL SERIAL NUMBER El WARRANTY <br /> []BALL COCK 1111 -_.., .. 0 CONTRACT <br /> ❑FLAPPER 0 SERVICE.CONTRACT <br /> 0 SUPPLY LINE ❑NORMAL <br /> ❑WAX SEAL&CLOSET BOLTS E-MAIL 0 RES. ❑ COMM. <br /> JOB ❑ <br /> C] DRAINS CLEANING LOCATION <br /> DESCRIPTION OF WORK <br /> ❑ KITCHEN SINK <br /> 0 WASHER LINE ...,� g ' <br /> 0 MAIN LINE °Gig€ a._ > .S`L.", ..�t. _r <br /> LAVATORY LINE - """ <br /> ❑TUB OR SHOWER .._.._.. F � ,' :` r .___ <br /> ED KITCHEN SINKC <br /> ❑SINK FAUCET : <br /> ❑SINK DRAIN <br /> Ei GARBAGE DISPOSAL , <br /> ❑AIR GAP .. <br /> ❑D1W CONNECTIONS ,..---.. _ --.-- v <br /> El TUB&SHOWER ----- <br /> 0 rue <br /> _ - _❑TUe VALVE <br /> ❑TRIP LEVER -- <br /> ❑SHOWER DIVERTER I <br /> TOTAL PARTS <br /> ❑TUB OR SHOWER DRAIN T 4'`' _ �.. <br /> ADDITIONAL PARTS(OTHER SIDE) <br /> Q NEW CONSTRUCTION OR ' i <br /> ❑CRAWL SPACE ROUGH ArIVITE "" <br /> DRAINAGE SUBLET ;'-. <br /> P.S.I. ___._.__ <br /> 0 SLAB ROUGH OTHER LABOR <br /> DRAINAGE a .. , _._ CHARGES HRS.@ fr.R = <br /> P.S.I. TOTAL OTHER CHARGES TEGHNIGIAN- TOTAL OTHER CHARGES <br /> LI TOP OUT SIGNATURE <br /> DRAINAGE PARTS WARRANTY <r c'= TERMS DUE UPON COMPLETION SUE- _'`:., . ._�-- <br /> P.S.L All parts as recorded are TOTAL 'a^' ,.* <br /> ❑SEWER-0R SEPTIC <br /> OUR TRAINED PERSONNEL SUGGEST warranted as per manufacturer I HAVE THE AUTHORITY TO ORDER THE ABOVE WORK AND DO SO <br /> THE FOLLOWING IMPROVEMENTS: specifications. i ORDER AS OUTLINED ABOVE.IT IS AGREED THAT THE SELLER WILL <br /> DRAINAGE LABOR GUARANTEE : RETAIN TITLE TO ANY EQUIPMENT OR MATERIAL FURNISHED UNTIL <br /> ❑WATER Thelabor charge as recorded here FINAL&COMPLETE PAYMENT IS MADE,AND IF SETTLEMENT IS NOT TRIP <br /> PSI relative to the equipment serviced + MADE AS AGREED,THE SELLER SHALL HAVE THE RIGHT TO CHARGE <br /> PRESSURE REGULATOR <br /> as noted,is guaranteed for a REMOVE SAME.AND THE SELLER WILL BE HELD HARMLESS FOR 64\ 10 <br /> St❑ period of 3D days. ANY DAMAGES RESULTING FROM THE REMOVAL THEREOF. ,�+� !'"S. <br /> ❑BOOSTER PUMP We do not,of course,guarantee § TAX `"' b,,,,3 <br /> 0 FINAL other parts than those we supply. i <br /> If repairs later become necessary 1 e <br /> 0 COMMERCIAL REPAIR due to other defective parts,they <br /> > El FLOOR DRAINS will be charged separately. � '�� <br /> n 0 D.NVASHERBOOSTER TRAVEL TIME „ �. 1 / 4 TOTAEw� /^yi <br /> ri. ❑GREASE TRAP L T!'AE „y„, • , �i - ~. "-,�""4", '' 1r ... ,Y ,)k.-1, <br /> t-' •' <br /> Q ARRIVED AUTHORIZEOEIGNATURE � i " <br /> TIME AI3 VE ORDERED WORK HAS BEEN COMPLETED AND I ACKNOWLEDG" ECEIPT OF MY COPY <br /> T 0 DEPARTED � // <br /> / P-WC <br /> IP <br /> 0 K TRAVEL X <br /> f TIME DATE <br /> I <br /> I <br />