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1510 SE EVERETT MALL WAY PERFECT SMILES 2016-01-01 MF Import
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1510 SE EVERETT MALL WAY PERFECT SMILES 2016-01-01 MF Import
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Last modified
4/12/2017 9:09:34 AM
Creation date
2/10/2017 1:52:22 AM
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Address Document
Street Name
SE EVERETT MALL WAY
Street Number
1510
Tenant Name
PERFECT SMILES
Imported From Microfiche
Yes
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Everet� WA 98201 <br />(425)741-0807 tax (425�968�620 <br />hltpllwwx.ai�gas.oam <br />II. Dental Air: <br />A. Static Line Pressure: 105 psig <br />B. Concentration of Oxygen: 20.8% <br />III. Dental Vacuum: <br />A. Static Line Vacuum: 13" HgV <br />IV. Particulate Line Testing: PASS <br />V. Odor: None — PASS <br />VI. Dental Equipment: <br />A. Dental Air: New <br />1. System air components are in compliance with NFPA 99(2005ed) <br />2. Brand Name: Midmark <br />3. Model Number: P52 <br />4. Serial Number: V1006538 <br />5. Configuration: Duplex <br />6. Horse Power: 1.6 <br />7. Air Intake: Inside — Other Space <br />8. Pump: Oil Less <br />B. Dental Vacuum: New <br />1. System vacuum components are in compliance with NFPA 99(2005ed) <br />2. Brand Name: Midmark <br />3. Model Number: Power Vac (029-3713-01) <br />4. Serial Number: V1085509 <br />5. Configuration: Simplex <br />6. Horse Power: 2.0 hp <br />7. Exhaust Vented Outside: Wall <br />C. Amalgam Separator: New <br />1. Brand Name: Solmetex <br />2. Model Number: Hg5 <br />3. Serial Number: CC-K-156272 <br />VII. Brazier: Jeff Head <br />A. Brazier Number: HEADJ016RP <br />B. Plumbing Contractor: Head Mechical <br />VIII. Witness: Alan Halvorson — Constantine Builders <br />IX. Comments: <br />A. None <br />GOWDA-10.14.11-201635 <br />Pg2of3 <br />
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