State of California
Department of Health Services
Water Treatment Device | |
Certificate Number | |
97 - 1291 |
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Date Issued: June 10, 1997 | |
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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 and Turbidity | Inorganic/Radiological Contaminants |
Cysts (protozoan) | Lead |
Turibidity |
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Organic Contaminants |
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None |
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Rated Service Capacity: 200 gallons | Rated Service Flow: 0.5 gpm |
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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:
Name
Address
City | State | Zip |
SignatureDate
SELLER:
Name
Address
City | State | Zip |
SignatureDate
24
