Installation Certificate - EcoWater CHC Installation & Service Manual

The undersigned hereby certifies that all items described below, leased/rented to the undersigned pursuant to the lease/rental agreement
between the Lessor/Seller and the undersigned (the "Equipment"), have been delivered, and that this Equipment has been accepted by
the undersigned and is now operational.
Unit Serial #:
Equipment
In the City
of
Company Name
S I
UBCONTRACTOR NFORMATION
Plumbing/Installation
Contractor:
Telephone #:
Electrical Contractor (if
applicable):
Telephone #:
O I
PERATIONAL NFORMATION
Date System
Operational:
(CHC Technician/Representative Signature)

INSTALLATION CERTIFICATE

DESCRIPTION
INSTALLATION INFORMATION
Chamber
Serial #:
Located
at
County
of
Customer Representative Signature
State
of
Date:
Date:
37