State of California
Department of Health Services
Water Treatment
Device
Certificate Number
00-1434
Date Issued:
May 30, 2000
Date Revised:
February
9, 2001
Trademark/Model
Designation
GE Smart Water Filtration
Replacement
Elements
GE Smart
Manufacturer:
Appliances
i
The water
tre_
,ant to Section
116830 of the
Microbiolo
Or
Turbidit_
Atrazine
Lindane
2,4-D
Rated Service
Capacity:
300 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.
* 500 gallons
for models
that include
a replacement
filter indicator
light.
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
42