SPE # ???
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Manufacturer/Client (Dropdown)
Model Name (Dropdown)
Model Type (Dropdown)
Test Site (Dropdown)
Scope of Certification
(Check box) -NSF/ANSI Standard 40
(Check box) -NSF/ANSI Standard 46
(Check box) -NSF/ANSI Standard 50
(Check box) -NSF/ANSI Standard 245
(Check box) -NSF/ANSI Standard 350
-Other (open field)
|
Item (link each to completed forms) |
Responsible GCT Employee | Date | Document Available |
|---|---|---|---|
| Contact form 216 | (Dropdown) | (Calendar) | (Yes / No / NA) |
| Unit Installation Form 218 | (Dropdown) | (Calendar) | (Yes / No / NA) |
| Equipment Evaluation Form 228 | (Dropdown) | (Calendar) | (Yes / No / NA) |
| Infiltration / Exfiltration Form 217 | (Dropdown) | (Calendar) | (Yes / No / NA) |
| In-Plant Audit Form 226 | (Dropdown) | (Calendar) | (Yes / No / NA) |
| Drawing / Schematic | (Dropdown) | (Calendar) | (Yes / No / NA) |
| Aerator | (Dropdown) | (Calendar) | (Yes / No / NA) |
| Diffuser | (Dropdown) | (Calendar) | (Yes / No / NA) |
| Alarm | (Dropdown) | (Calendar) | (Yes / No / NA) |
| Data Review | (Dropdown) | (Calendar) | (Box - Written) |
| SPE Report Form 119 | (Dropdown) | (Calendar) | (Box - Received) |
| Criteria Evaluation Form 235 | (Dropdown) | (Calendar) | (Box - Approved) |
| Approval / Denial of Certification | (Dropdown) | (Calendar) | (Box - Approved / Denied) |
| Posted on Website | (Dropdown) | (Calendar) | (Yes / No) |
| Reports Sent to Client | .......................................................... | .............. | ...................................... |
| SPE Report Form 119 | (Dropdown) | (Calendar) | (Yes / No) |
| Certification Certificate Form 221 | (Dropdown) | (Calendar) | (Yes / No) |
| Authority To Use Mark From 224 | (Dropdown) | (Calendar) | (Yes / No) |
| Official Listing Form 223 | (Dropdown) | (Calendar) | (Yes / No) |
Program Manager
Name: (Dropdown)
Date:(Calendar)
QA/QC Manager
Name: (Dropdown)
Date:(Calendar)
Laboratory Manager
Name: (Dropdown)
Date:(Calendar)
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