GE 22 Manuel D'utilisation page 36

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
Signature
36
State of California Department of Public Health
Water Treatment Device
Certificate Number
05-1698
Date Issued: February 2,2010
Modified June 25, 2013
Trademark/Model Designation
GE MWF
Manufacturer: General Electric 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
Cysts
Organic Contaminants
Carbofuran
Endrin
p-Dichlorobenzene
Benzene
Atrazine
Lindane
Tetrachloroethylene
Toxaphene
2,4- D
Rated Service Capacity 300 gallons
Conditions of Certification
Do not use where water is microbiologically unsafe or with water of unknown quality, except that systems
for cyst reduction may be used on disinfected waters that contain filterable cysts.
SELLER:
Name
Address
Zip City
Date Signature
(on some models)
(on some models)
Replacement Elements
MWF
PLWF
Inorganic/Radiological Contaminants
Asbestos
Lead
Mercury
Rated Service Flow: 0.5 gallons per minute
State Zip
Date