GE 24 CustomStyle Water Treatment Device Certificate Number 97-1291, Trademark/Model Designation

Models: 24 CustomStyle 162D9617P008 49-60021-2

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State of California

State of California

Department of Health Services

Water Treatment Device

Certificate Number

97-1291

Date Issued: June 10, 1997

Trademark/Model Designation

Replacement Elements

GE Water by Culligan Filtration System FXRC

None

Manufacturer: Culligan International Company

 

 

 

 

 

The water treatment device(s) listed on this certificate have met the testing requirements pursuant to Section 116830 of the Health and Safety Code for the following health related contaminants:

Microbiological Contaminants

Inorganic/Radiological

and Turbidity

Contaminants

Cysts (protozoan)

Lead

Turbidity

 

Organic Contaminants

 

None

 

Rated Service Capacity: 200 gallons

Rated Service Flow: 0.5 gpm

Do not use where water is microbiologically unsafe or with water of unknown quality, except that systems claiming cyst reduction may be used on water containing 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

State

Zip

 

 

 

 

 

 

 

Signature

 

Date

 

Signature

 

Date

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GE 24 CustomStyle Water Treatment Device Certificate Number 97-1291, State of California Department of Health Services