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i <br /> " �� , BING <br /> SEre 'C <br /> F-1WATERHEATER -CHEC-k US <br /> ESIDEi.,I IAL <br /> g <br /> ❑ELEMENTS ' "'528 18 � AVE. RE, <br /> ,-. <br /> THERMOSTAT'. �`',,M <br /> F <br /> ❑ .. '` ._,a"'" `v.5 a�T"L',`V 3 i t Ir.:....+p g`�a"i. a�...1�:', DA <br /> µ . <br /> ❑RELIEFVALVE. <br /> ? [`]DiPTUBE .a'^� ;."a. $Q✓' DATE ORDERED <br /> I ❑ELECTRICAL CONN. <br /> -- �n DATESCHEOULED <br /> GAS WATER HEATERS NAME � <br /> r <br /> ❑ <br /> THERMOCOUPLE <br /> PHONE STREJ -� <br /> ❑BURNER ,; •. <br /> ❑FLUE PIPE CITY STATE zip WK.PHONE <br /> ❑RELIEFVALVE <br /> { <br /> TOILET - MAKE MODEL SERIAL NUMBER ❑WARRANTY <br /> ❑CONTRACT <br /> ❑BALL COCK ❑SERVICE CONTRACT <br /> ❑FLAPPER... <br /> ❑NORMAL <br /> ❑SUPPLY LINE <br /> ❑WAX SEAL A CLOSET BOLTS E-MAIL ❑RES. ❑ COMM. <br /> doe ❑ <br /> LOCATION <br /> DRAINS CLEANING DESCRIPTION OF WORK <br /> E <br /> ❑ Y.ITCHEN S)NK —_i <br /> ,�s f,..� ,,. i 1. r 1✓ t <br /> ❑WASHER LINE � - <br /> ❑MAIN LINE <br /> ❑LAVATORY LINE <br /> ❑TUB OR SHOWER <br /> ❑ KITCHEN SINK "�.��r a� ✓ ,n. <br /> x• <br /> ❑SINK FAUCETE]SINK a. <br /> _DRAIN . . <br /> ❑ <br /> GARBAGE DISPOSAL <br /> F-1 AIR GAP �( �._._..w. •..__�-.. <br /> k ❑DIW CONNECTIONS a� t <br /> [Q TUB&SHOWER <br /> p TUB VALVE __-- <br /> TRIP LEVER on <br /> ❑ <br /> SHOWER D€VERTER TOTAL PARTS <br /> ❑TUB OR SHOWER DRAIN <br /> ADDITIONAL PARTS(OTHER SIDE) <br /> 3 <br /> F--j NEW CONSTRUCTION OR <br /> Z .❑CRAWL SPACE ROUGH <br /> DRAINAGE SUBLET _ <br /> R&L LABOR <br /> ❑SLAB ROUGH OTHER ,� CHARGES HRS.@ IHR.._DRAINAGE—TECHNICIAN TOTAL OTHER CHARGES <br /> SIGNATURE �• ' <br /> ❑TOP OUT SUE- :a""i` f-':•.•` <br /> DRAINAGE PARTS WARRANTY i `• i ® 3� <br /> All pmts as retarded are Tt3TAL <br /> Rs,L OUR TRAINED PERSONNEL SUGGEST avarranted as per manufacturer I HAVE THE AUTHORITY TO ORDER THE A80VE WORK AND DO SO <br /> ❑SEWER OR SEPTIC THE FOLLOWING IPJIPROVEMENTS: speclfica#ions. ORDER AS OUTLINED ABOVE_IT IS AGREEDTHATTHE SELLER WILL <br /> ( <br /> DRAINAGELABOR GUARANTEE RETAIN TITLE TO ANY EQUIPMENT OR MATERIAL FURNISHED UNTIL <br /> WATER The labor charge as recorded here FINAL&COMPLETE PAYMENT IS MADE,AND IF SETTLEMENT IS NOT TRIP <br /> j relative to the equipment serviced MADE AS AGREED,THE SELLER SHALL HAVE THE RIGH X70 CHARGE <br /> as noted,is guaranteed for a REMOVE SAME AND THE SELLER WILL BE HELD HARMLESS FOR } <br /> ❑PRESSURE REGULATOR period of 30 days. ANY DAMAGES RESULTING FROM THE REMOVAL:THEREOF. TAX <br /> CJ BOOSTER PUMP Wade not,of course guarantee <br /> i ❑FINAL other parts#hanthose wesupply. <br /> if repairs later become necessary } <br /> I Q COMMERCIAL REPAIR duetoother detective.part%they <br /> [I FLOOR DRAINS will be charged separately. VT 3# i. - AY <br /> El DPNASHER BDOSTER TRAVELTIME -�' ' ♦ 4�t <br /> fGREASETRAP' L TIME _.........—..._....... ......_ C. _.._: — F a <br /> OO ARRIVED AUTHORIZEDSIGNA RE <br /> F <br /> m C <br /> c _A TIME ABOVE ORDERED WORK HAS.13EEN COMPLETED AND(ACKNOWLEDGE RECEIPT OF PAY COPY.- <br /> E< To DEPARTED <br /> R �( <br /> N K T RAVEL - DATE <br /> TIt6- _ <br />