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State of Calitbrnia
Department of Health Services
Water Treatment Device
Certificate Number
05 - 1698
Date issued: February 2, 2005
Trademark/Model Designation
MW]:
Replacement Elements
Manufacturer: Generall_lectricCompany
]he water treatment device(s) listed on this cm
116830 of the Health and Safety Code for the
_rsuant to Section
MicrobiologicalContaminants and Turbidity
Cysts
Turbidity
Organic Contaminants
Alachtor
Atraz_ne
Benzene
Carbofuran
Lindane
Mercuu
Toxaphene
1A-dichlorobenzene
2.4-D
Inorganic/Radiolo_ical Contamin ants
Rated Service Capacity: 300 ga] ! , Rated Service Flow: 0.5 gpm
Conditions of Certification:
Do not use where water is microbio!ogically unsafe or with water of unknown quality, except that systems certi ed for
cyst reduction may be used on disinfected waters that may contain lterable cysts.
For Purchases Made In Iowa: This form must be signed and dated by the buyer and seller prior to the consummation
of this sale. This form should be retained on file by the seller for a minimum of two years.
BUYER: SELLER:
Name Name
Address Address
City State Zip City
Signature Date Signature
State Zip
Date
26
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