31A-328 (3) Site ID: 300 E--y'Ck--S Address:
KN-C) r , 4 1 kaon off letter
During ilte Energy Sirr,;c; of}=o,r}omc,tndic:.at€-t.s of°"knoll and tube"wvrrin5 were found.This old style o wirin
involves individr.arl hires H-tat are run through walis and c cilinl s in a house with ce rnic"knobs"and"tubas"to
pre cvr contract with e,oocl Craming.The;lob,and tube wi.rm�that has hem noted rraera-or arca rrnt rt11=r;r to 1,
rxli e.Even if`the obsc nen wiring appears to by inactive.there may still be active knob and tribe circuits hidden
r€aside waills or otErcr in ac c.r.;srble areas of the house,
The Natioml Cind Program rquiren-W its require that you have Lie horue checked by a licensed elecir;c€an and
eertificd ars beingfi-ee gfall active knob&Iube wiring where rreede d..before insulation°anrd-irr air scaling Durk can
lie demi°e,Your r electrician;houhl til(mi and rulltr.it a.,'r~p ,ofthis sfo:trtacznt io RISE Fogrhwerinr1 In,girder to vcrifi+
the ab�,encc ofor€nu t€v itv offtl, knob and Wbe'W°rin:;in nhe are:ss of;ou-,—home Where we are proposing insulation
!o he installcotrue t,the liabilu� ins;caryerd in signing such;a form we s,,!nest vont dhow OT describe this form to
vtaccr cl°ccm!,uixa bear hiring hun to hasp;ct vour homc to be sura he/she ji willing to sign it. RI:?I:F.,ninr3cerirtg and
°laflorral Grid will rely on tlAe cloctriciau uvtcrn inat on and :ertif catkin below and will not be liable;if inacc€ratz.
our hoes could benefit from insulation an%-tor air soling i
the,
® Open. r tti rior W.-HP BaRment
Attie: Floor Knee Nk"all :Floor
"Only after this certifications received by RISS Engineering
can a Contract be iss I d for energ saving g insui. doand/or sir
s aline work."
Electrician's Certification
(This form is invalid when any quallfications or alterations
are added.)
Company Name 8z Address-
�.
J trician's Name:
License
have erl`ornri d aninspection. of the wiring t the home of:
5 _ - at CL...... ...�?
(amu: rt o sir of q, r l i% 0
(Owner's Name) 9-d atm � ( Street Address;
City
Upon completion of my in pecti n .l have found that there is no
actI e knob and tube wi- in the area(s) i ioted below.
Open Attg F. riorWallsg �men
Attic Foo- Kees NVall Floor
11,Ur .