HomeMy WebLinkAbout639 Stoneham Ct - Special Inspections/Combustion Safety - 07/20/201501-y.
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PIZ-11111ing, Development & Tral-ispol,t-LItIol, Services
q9n"lltlnllYDevelopment SNeighborhood Services
251 Norl.li College Aventie
13.0. Box 560
Fort Collins, CO 80522.0580
070.410.2740
070.22,1.6134- fax
fcgov.con)
Combustion safety Test C0111plialice Florin
IN"Op 1.1 cc III ell (.0 1 Natural Di-,11't Appliances ill 1s,Ki.stijlg -[Uuses
Address:.— ls�-104,5 HAM Cl—
Permit Number:
IM-
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Approved Agency:
jIr:.I-Cby 'mr-st that 1 Jl'Ivc I)CC11 (rained as all Approved Agcticy and IlElyc
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COMIRIS(ioll silf. ct Of Olect the following3 rcst ill accordance Avittl.Forl Collins CoijibLlStjoll Sat'c[yrcst CjUidC
Version 5, Feb I-Lun-y 2012.
'rechiliciall Namc (print):. r'- .
Coillpally--S-- 'f Ai
Date -7-
ZO
m
Aliphance
A)"W'st CIsc Conditiolls:,;pillage Durn�iort.(iil se •onds
A0 Carbon Wiloxi(lc (parts per million):
Pciss v , . .
Fail
Nautnil CORCHU011N...
Spillage JDLI'm
Carbon Monoxide (palls per million):
DAte Te�;tcd-
' 7-
(Vailed test -ei Lres currectiolls
11116.1 telYtPaSses under Natural Conditiolls,)
% Ccoillmenc atiolls- to Wrl'ecL tested '11; j) I i,.uic c t1i ILI r C:
coliclid.011s
I certify that I <tllj-'1116 JC2sfi..61iflcr a - f (lie ,above listed property
and Ile! ebY-,IcJ('luwIcdgc.tjI�It my appli,111ce
11".1"s failed EI.Caiiibti,�Lloii:s-,Ifc(y.,I,co.t uI1dcl:W01*st-Q�lse colid I
zippliZI, C safely infrilli . la'tioll sheet. ac.kflmv1cdL4c that I 11�jvc received
Owiler"s SigIMWI:0,