Trademark/Model
Designation
GE Smart Water Filtration
S
GE Smart
State of California
Department of Health Services
Water Treatment Device
Certificate Number
00- 1434
Date Issued:
May 30, 2000
Date Revised:
February 9, 2001
Replacement
Elements
WF06
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ManufactHrer:
Micr{
Cysts (1
nants
Organic
2,4-D
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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
he retained
on file by the seller
for a minimum
of two years.
BUYER:
SELLER:
Name
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Address
Address
City
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City
Signature
Date
Signature
28
State
Zip
Date