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� INtiULATiON CF.ItI'IFICATION �n <br />hi1I5 (iYU) 15 70 Hk}N1N H7p5W?lI1.Y ItSI}]1 IN A Wi1UlLY /iSL55IWf, t[A/(('IWi <br />iill5 IS TO C8RTIPY 'pY�T IR CONFONMANCg WITN THE CUNRLNT TIIHNMAI, pENfJNMANCH StANUMUS <br />YASNIIICI'ql S7ATE F.N6RCY COOL, CIIM. 51-12 NAC, IlEVI5E0 1986, AHD APPpOVED PI.AlIS, I HAV6 <br />IMSP6CT6D TIIIS CNEpCY P�CIIhGE ANU CF.NTIFY TIIAT It IIAS IIEEN INSTALLEU IN f.CCONDANCB 4[711 <br />I7105L STANUARpS 1N 77�e OUILUINC IACATEU AT: <br />tlW IF]MLT N1. <br />ffSOtIPl1?! �' ItSI'NIATIQ7 <br />R70FS <br />7ypc a( lbterinl Wuuf�cW�er 7Licknas N Value <br />F]05Rial NNLi -- - <br />lype o( Me[erial FI�H7AASS ltrou(a�Wrer arun� lhiclueae ,--�' ��R Val�c /_i <br />�[1.I1iS <br />M775: <br />lype o[ Nicerial���ufxturer��rrriszi�. thicJuxsa H Value <br />Sq. R. Ca�ertd - - <br />�QN: <br />lype o( Natcriel FIB�ASS ILyufaWrer�R7'A1N1471 'p�ickrcac�tb.geqe�� <br />-?S� 4k./B�Sq. F[. Covered,�C' RVelue <br />F7Qllt5 <br />Type u[ !Wc¢rial iI9Q+IIASS lWnifaturerff'RfAIMf}7� '1liickneseG✓yN Volu� <br />9AB U7 OWE <br />7ype o( lfacerial Haru(rwrtr Thiclmees H Yalue <br />Midth o[ I�dacim irrlme -- <br />FUMNTIUI NNJS (i[ requirecl) <br />Type oE lWterial llvufxl irer Thickrcse H Velue <br />0.C15 NU/Ul PLE 11&MI1(�1 - <br />lype of lWcerial r�iuLrturer �tl�icMreee e; Value <br />IEA7'ItG SYSIFTI - --- <br />Ty{eafSypUm_____qy„�fxturer ___.In�xrt fLtprt�. <br />� NitlR �NM7( 1tFJlC6TAf IISI'NIt71 <br />L1 FFATIlC SYS@I I1SCNlFl1 '�O N) Ml1E TirW I`OI ll' ILSI(N Id�) <br />d QA7•l!C - Nl. aqZlf� IlL�tM7tI) []/SS � g��apt IJWAdS pq)yIlM1� <br />0 M7FJt lFiUk715 - A9W1E 9fN-BIl IMi.'_FD <br />��� � RF3�R��101S - NL 9lld'RS L'hil'IFll'10 7 �TI <br />0 1lF�.7AAitQFppp�S 6 IIfNS3/5 IFA714FSINtYPEI) pi ppp�ym yy /SIH 28}7J <br />� 11FIL'OUTIUL-NL �F77IN6 W ECIflUGH 4AIL5 CN1U}D Ui g'N1�J� <br />O�1hP1/lF5-qllSIIE AIA VFM (SLX :l�7/�7: IW6:;) ��1TI W�H47t lu FINFl1o7c <br />� 9/9 IIt7MV. BPFN( QIFI(If1� <br />� VM7t &WUFA4IASTNIFD Itit lllt'. <br />O P1')Wi(5 (i! desirnl) <br />I CERTIFY UN�EX PENALTY OF PENJIIRy UNOER TIIE LANS OF 7'IIC STATE UF HASH[NGTON <br />171Ai THE FORGOING 15 TNUE ANU CONNECl'. <br />Qmeral (7on[r/r�:tor(9iilder) fmcraccor'e prg. Ib. <br />�- F�L�a / Title <br />Uale 6 Ylace ��"�Q' <J � <br />9bcanLrctor (t�wulatim NylicuLur) N:I Qntre�tor'e Heg. tb.�IIIM121d8 <br />��}�'� �Y. Kr�.) (State "SMF," if wn• u Crrenl luntra�[ur) <br />Uate 6 Plae <br />