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State of California
Department
of Health Services
Water Treatment Device
Certificate Number
97-1291
Dale Issued: June
1O, 1997
Trademark/Model
Designation
(;E Water by Culli_an
Filtration
Syslem FXR(
Manufacturer: (aflh_an hnernanonal
(,ompany
Replacement Elements
None
The water treatment de vice(s) listed on this certificate have met the testing requirements pursuant to Section 116830of the
Health and Safety Code for the following health related contaminants:
Microbiological Contaminants
and Turbidity
Cysts (protozoan,
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 fi)rm must
be signed
and
dated
by the buyer
and seller
prior
to the consummation
of this
sale. This fi)rm should
be retained
on file by the seller
for a minimum
of two years,
BUYER:
SELLER:
Y_e
Y_e
Address
Ad(hess
(i/y
Stale
Zip
(i/y
Signature
Date
Signature
State
Zip
[)ate
24
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