Backup Documents 09/13-14/2011 Item #16C 7ORIGINAL DOCUMENTS CHECKLIST & ROUTING S P
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO C 7
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNA
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed routing slip and original
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ROUTING SLIP
Complete routing lines #I through #4 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the
exception of the Chairman's signature, draw aline throu h routing lines #1 through #4, complete the checklist, and forward to Sue Filson (line #5 ).
Route to Addressee(s)
List in routing order)
Office
Initials
Date
1.
appropriate.
(Initial)
Applicable)
2.
September 13, 2011
Agenda Item Number
16C7
3.
signed by the Chairman, with the exception of most letters, must be reviewed and signed
4.
Executive Summary, Resoluti( p, �K atA,
[
Number of Original
1
5. Executive Manager
Board of County Commissioners
Documents Attached
6. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. Normally the primary contact is the person who created(prepared the executive
summary. Primary contact information is needed in the event one of the addressees above, including Executive Manager, need to contact staff for additional or
missing information. All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve
the item.)
Name of Primary Staff
Peter Lund
Phone Number
252 -2357
Contact
appropriate.
(Initial)
Applicable)
Agenda Date Item was
September 13, 2011
Agenda Item Number
16C7
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
Attached
Executive Summary, Resoluti( p, �K atA,
[
Number of Original
1
Exhibit B and Samples
Documents Attached
INSTRUCTIONS & CHECKLIST
Filing Fees: 408 - 210151- 649030
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(Initial)
Applicable)
1.
Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and possibly State Officials.)
2.
All handwritten strike - through and revisions have been initialed by the County Attorney's
rn
Office and all other parties except the BCC Chairman and the Clerk to the Board
J�
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
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document or the final negotiated contract date whichever is applicable.
J�
4.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
^ G
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
should be provided to the Executive Manager in the BCC office within 24 hours of BCC
approval. Some documents are time sensitive and require forwarding to Tallahassee within
a certain time frame or the BCC's actions are nullified. Be aware of your deadlines!
6.
The document was approved by the BCC on 9 -13 -2011 enter date) and all changes
made during the meeting have been incorporated in the attached document. The
County Attorney's Office has reviewed the changes, if applicable.
Filing Fees: 408 - 210151- 649030
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
16 C7
MEMORANDUM
Date: September 23, 2011
To: Peter Lund, Manager
Utility Billing and Customer Service
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Resolution 2011 -145: Establishing a procedure for CWS
customers to receive credit adjustments based on cooling
tower water evaporation
Attached for your records is a certified copy of the document referenced
above (Item #16C7) adopted by the Board of County Commissioners on
Tuesday, September 13, 2011.
The original document will be held in the Minutes and Records Department
for the Board's Official Record.
If you have any questions, please feel free to call me at 252 -8406.
Thank you.
Attachment
16 C7
EXECUTIVE SUMMARY
Recommendation to approve a Resolution revising the procedure by which Collier County Water -
Sewer District customers receive credit adjustments for cooling tower water evaporation,
superseding and replacing the current procedure established by Resolution No. 2002 -365.
OBJECTIVE: That the Board of County Commissioners (Board), as governing body of Collier
County and as ex- officio the governing board of the Collier County Water -Sewer District
(CCWSD), approve a Resolution which supersedes Resolution No. 2002 -365 and establishes a
revised procedure for cooling tower water evaporation adjustments.
CONSIDERATIONS: The normal operation of cooling towers causes significant water
evaporation, thus reducing the amount of metered potable water that eventually returns to the
sewer. By recording the inflow water volume and the outflow water volume, the amount of
water lost to evaporation can be calculated, and the sewer volume charges reduced accordingly.
Through Resolution 2002 -365, the Board authorized the Public Utilities Division Administrator
or his designee to execute written agreements with individual property owners for installation of
"cooling tower deduct meters," which calculate the evaporation. Property owners were required
to submit a formal application and adhere to all procedures, and the meters were installed,
maintained, and read by the CCWSD.
The CCWSD is self - supporting through the customer fees received monthly for the services
provided. Property owners with cooling towers obtain the specific benefit, over and above other
customers, of reduced sewer charges through the calculation of water evaporation. The
proposed procedure shifts the responsibility to the property owner, for installing, maintaining,
reading the inflow and outflow meters, and replacing the meters every ten years at no cost to the
CCWSD. The CCWSD will inspect the installation for compliance with CCWSD Utility
Standards. The property owner will then be required to provide monthly reads of both the inflow
and outflow meters in order to receive the sewer adjustments. Additionally, the property owner
will be required to provide annual meter calibration test results to the CCWSD.
The procedure and a draft example of the application form are attached as Exhibits A and B to
the proposed Resolution.
FISCAL IMPACT: The chart below illustrates the savings to the CCWSD Operating Fund (408)
(per cooling tower based on standard meter tapping charges) by transferring the responsibility for
meter installation and maintenance to the property owner.
Activity
Savings
2" meter tapping charge X 2 at $1,213.00
$2,426.00
Meter replacement after 10 years, assume 2 X $121.30 per year
$242.60
Total
$2,668.60
16 V
LEGAL CONSIDERATIONS: Ordinance No. 01 -73, Section 1.3, G. l provides, in pertinent part:
"Any debit or credit adjustment for any District service can only be made as a result of a
documented and approved procedure." This item is legally sufficient and requires a majority
vote.- JBW
GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with
this action.
RECOMMENDATION: That the Board of County Commissioners, as governing body of Collier
County and as ex- officio the governing board of the Collier County Water -Sewer District,
approve the attached Resolution, which supersedes and replaces Resolution No. 2002 -365, and
establishes a revised procedure for Collier County Water -Sewer District customers to receive
cooling tower water evaporation adjustments.
PREPARED BY: Peter Lund, Manager, Customer Service and Education and Compliance,
Utility Billing and Customer Service
16 C7
RESOLUTION NO. 2011 - 14 5
A RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, AS
GOVERNING BODY OF COLLIER COUNTY AND AS EX-
OFFICIO THE GOVERNING BOARD OF THE COLLIER
COUNTY WATER -SEWER DISTRICT, ESTABLISHING A
PROCEDURE FOR COLLIER COUNTY WATER -SEWER
DISTRICT CUSTOMERS TO RECEIVE CREDIT ADJUSTMENTS
BASED ON COOLING TOWER WATER EVAPORATION AND
SUPERSEDING AND REPLACING THE CURRENT PROCEDURE
CREATED BY RESOLUTION NO. 2002-365.
WHEREAS, the operation of cooling towers causes significant water evaporation thus
reducing the amount of metered potable water that eventually returns to the sewer; and
WHEREAS, in accordance with Ordinance No. 2001 -73, Section 1.3, G.1, Collier
County Resolution No. 2002 -365 established the procedure by which Collier County Water -
Sewer District customers who utilize cooling towers could receive credit adjustments based on
this water evaporation; and
WHEREAS, the Board of County Commissioners, as governing body of Collier County
and as ex- officio the governing board of the Collier County Water -Sewer District, desires to
supersede and replace Resolution No. 2002 -365 and establish a new procedure for District
customers to receive these credit adjustments.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, AS THE GOVERNING BODY OF
COLLIER COUNTY AND AS EX OFFICIO THE GOVERNING BOARD OF THE COLLIER
COUNTY WATER SEWER DISTRICT, that:
1. The Collier County Water -Sewer District "Procedure for Adjustment of Customer
Accounts for Cooling Tower Water That Does Not Return to the Sewer," attached
hereto as Exhibit A, is hereby adopted.
2. The application for cooling tower monthly water evaporation adjustment, as
required by the procedures set forth in Exhibit A, shall be in substantially the
form attached hereto as Exhibit B.
16C7
Resolution No. 2002 -365 is hereby superseded and replaced in its entirety.
THIS RESOLUTION ADOPTED after motion; second and majority vote favoring
adoption on this the Z,3 7.11 daySEP rcXJ-?E lR , 2011.
ATTEST:
DWIGH`LjF,,. C , CLERK
By: .
fluty Clerk
Approval as to form
and legal Sufficiency:
Jennife . White
Assistant County Attorney
2
BOARD OF COUNTY I�IMT$SIOI RS,`',
T
OF COLLIER COUN FLORIb
THE GOVERNING B(I3Y Q, COLLIER
COUNTY AND AS girr '-OA'IC " � I� I'Ht
GOVERNING BOARD &, THE1-'COLLIJ4'
COUNTY WATER SEWERJ)ISTRIC IF'
.`
By:
FRED W. COYLE, CHAI N
Item #
Agenda
Date
Date q'
Redd
16 C7
EXHIBIT A
COLLIER COUNTY WATER -SEWER DISTRICT
PROCEDURE FOR ADJUSTMENT OF CUSTOMER ACCOUNTS
FOR COOLING TOWER WATER THAT DOES NOT RETURN TO THE SEWER
PURPOSE
The purpose of this Collier County Water -Sewer District (CCWSD) procedure is to provide a
credit adjustment to the water and/or sewer account of a property owner who has a cooling tower
wherein water evaporation reduces the amount of registered water volume flowing through the
cooling tower inflow meter to that registered at the cooling tower outflow meter. The volume
difference between the inflow and outflow meters will be used to calculate a credit adjustment
with respect to the volume of water that has not returned to the CCWSD sewer system.
CONDITIONS
A credit adjustment shall be considered for cooling tower water evaporation upon completion of
the following steps:
1. The property owner has completed an application form (see Exhibit A) and submitted to
Utility Billing and Customer Service (UBCS) for approval
2. CCWSD has approved the proposed placement of the inflow and outflow meters that will
determine the water loss due to evaporation
3. The property owner installs and maintains (including replacement at a minimum of every
ten years) the inflow and outflow meters at no cost to CCWSD
4. CCWSD has completed an onsite inspection and approved that the installation meets
Collier County Utility Standards
5. The property owner provides via email to UBCS, monthly meter reads from both the
inflow and outflow meters by an agreed due date, the reads being confirmed with meter
register photographs
PROPERTY OWNER RESPONSIBILITY
1. The property owner must complete a Cooling Tower Adjustment Application Form and
submit to UBCS
2. The property owner must provide drawings and calculations by the Engineer of Record,
for the cooling tower water flows to CCWSD, to include, but not limited to the placement
of inflow and outflow meters and any associated cross connection control devices. The
property owner will be responsible for the supply and installation costs of the meters and
associated pipe work and devices
3. The property owner will advise CCWSD when installation work commences
4. The property owner will advise CCWSD when the installation is completed and ready for
inspection
5. Following approval by CCWSD that the installation meets Utility Standards the property
owner will provide monthly reads of both the inflow and outflow meters to UBCS at
Page 1 of 2
Cooling Tower Adjustment Procedure
16 G'/
collierbilling(iDcollier ov.net . The reads will be emailed together with photographs of the
meter registers, including meter serial number, to evidence the reads by the due date
advised by UBCS. The property owner will replace at a minimum of every ten years both
the inflow and outflow meters and provide confirmation to UBCS.
6. The property owner will allow right of access to CCWSD employees to inspect the
cooling tower and inflow and outflow meters at all reasonable times
ADJUSTMENT PROCEDURE
A. On receipt of the monthly inflow and outflow meter reads from the property owner,
UBCS will confirm the reads with the photographs provided
B. Any reads not evidenced by photographs will not be processed until photographs are
provided by the property owner
C. The difference between the inflow and outflow meters, the water loss due to evaporation
(WLE), will be used to calculate a sewer adjustment for each monthly bill for the
customer account providing water /sewer service to the cooling tower. The sewer volume
charge based on the water consumption registered at the potable water meter for the
account will be reduced by an amount calculated based on WLE, using the current
wastewater rate
D. The UBCS Billing supervisor will undertake random sample quality checks of cooling
tower credit adjustments and all adjustments will be reviewed and approved or denied by
the Utility Billing & Customer Service Manager before a credit adjustment is made to the
customer's account
E. The credit adjustment will then be applied to the next bill
GENERAL INSTRUCTIONS
A. In accordance with Utility Billing & Customer Service procedures a copy of the Cooling
Tower Credit Adjustment form will be scanned and attached to the customer account
B. Annually the recorded WLE will be audited by UBCS to review credited gallons against
Engineer of Record estimates, with follow up as necessary with the property owner
IMPLEMENTATION
The Utility Billing & Customer Service Manager, or his or her designee, shall be responsible for
implementation and interpretation of this procedure and is authorized to exercise the applicability
of this procedure to any property owner requests for cooling tower credit adjustments.
July 2011
Page 2 of 2
Cooling Tower Adjustment Procedure
EXHIBIT B 16 C7
Co er County Collier County Utility Billing
APPLICATION for COOLING TOWER MONTHLY WATER
EVAPORATION ADJUSTMENT
Please print clearly when completing this application form.
Utility Account No.
Name on Utility Account (Property Owner):
Folio Numbers:
Service Address:
City, State, Zip + Four:
Naples Phone No. :
Email Address:
Alternate Phone No. :
Owner(s) Agent:
(Provide written evidence of Designated Agent's /Officer's authority to execute legal documents for property owner)
Contact Person:
(This should be person able to discuss operation of cooling tower and meet Water Distribution onsite for inspection).
Pos
Phone Number:
Email Address:
****************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Coolie Tower Information
Meter Sizes: Inflow
Meter Manufacturer and Model:
Outflow
Engineer Estimate of daily demand of water cooling tower:
Manufacturer:
Location of Cooling Tower within Facility:
By signing this application, the property owner recognizes and agrees to abide by all existing rules and regulations
of the Collier County Water -Sewer District (CCWSD), and any amendments thereto, copies of said rules and
regulations and amendments thereto being available for inspection at Utility Billing and Customer Service (UBCS).
The property owner also agrees to:
1. Provide written evidence of Designated Agent's /Officer's authority to execute legal documents for property
owner
Page 1 of 2
16 C7
Co e-r County Collier County Utility Billing
2. Provide signed and sealed drawings and calculations by the Engineer of Record, for the cooling tower
water flows to CCWSD, to include, but not limited to the placement of inflow and outflow meters and
associated cross connection control devices
3. Advise CCWSD when installation work commences together with Building Permit number
4. Advise CCWSD when the installation is completed and ready for inspection
5. Receive from CCWSD a formal notice of approval that the installation is complete and meets Utility
Standards
6. Provide, following approval by CCWSD, monthly reads of both the inflow and outflow meters to UBCS,
The reads will be emailed to coil ierbilling a,collier og_v.net together with photographs of the meter registers,
including meter serial number, to evidence the reads by the due date advised by UBCS. Replace at a
minimum of every ten years both the inflow and outflow meters and provide confirmation to UBCS.
7. Allow right of access to CCWSD employees to inspect the cooling tower at all reasonable times
Printed Name of Property Owner (or Designated Agent)
Signature of Property Owner (or Designated Agent)
Printed Title of person signing if Corporation:
Date
Please complete the form and return to: collierbilling_gcollier ov.net
Collier County Utility Billing & Customer Service, 4420 Mercantile Avenue, Naples, FL 34104
****************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
This section to be completed by CCWSD after site inspection visit:
Date of Inspection:
Installation complete and in accordance with CCWSD Utility Standards
Inspected by (Print Name):
Signature:
Engineer of Record Drawings and Calculations received and reviewed?
YES
NO
Applicant's Corporate Authority (if applicable) verified?
YES
NO
Approval:
Water Distribution Manager
Date:
Forwarded to UBCS to be associated with Utility Account on:
Page 2 of 2
RESOLUTION NO. 2002 - 3 f;5
A RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, AS THE
GOVERNING BODY OF COLLIER COUNTY AND AS EX-
OFFICIO THE GOVERNING BOARD OF THE COLLIER
COUNTY WATERISEWER DISTRICT TO AUTHORIZE THE
PUBLIC UTILITIES ADMINISTRATOR OR HIS DESIGNEE TO
EXECUTE COOLING TOWER DEDUCT METER AGREEMENTS
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA, and as the Governing Body of Collier County
and as Ex- Officio the Governing Board of the Collier County Water /Sewer District, that:
1. The Public Utilities Director (James W. DeLony) or his designee is hereby
authorized on the Board's behalf to execute written agreements for cooling
tower deduct meters with the property owners.
2. Owner must submit a formal application and all procedures must be
adhered to.
3. A draft example of the subject Agreement is attached as Exhibit "A ".
This Resolution adopted this ,/6-;M day of , 2002 after
mption, second and majority vote favoring adoption.
ATTEST:
DWIGH"Al E.-SROCK, CLERK
By:'
y: zaA
_• Deputy Clerk
Attest as to Ch,lre,nn.!
=190eture only.
Approved as to form and
legal sufficiency.
�
�6
y x�
Thomas C. Palmer,
Assistant County Attorney
1A C7
BOARD OF COUNTY COMNESSIONERS'.';:
COLLIER COUNTY, FLORMA, A
POLITICAL SUBDIVISIONOFTHE:
STATE OF FLORIDA, AND AS EX-
OFFICIO THE GOVERNING 60ARO
OF THE COLLIER COUNTY
SEWER ANCOLOET6TA,4CFMIRMAN
BY:
J
AGREEMENT FOR COOLING TOWER
P�
N READINGS, 16 C
REDUCTION METER INSTALLATIO ,
INSPECTIONS AND MAINTENANCE
THIS AGREEMENT, is entered into this day of , by
and between the COLLIER COUNTY WATER -SEWER DISTRICT, with its principal place of
business at 3301 East Tamiami Trail, Naples, FL. 34112 ( "District "), and
, ( "Owner') with its principal address as
City , ST. , Zip Code,
WHEREAS, Owner has requested that the District install a cooling tower reduction
meter to measure evaporation loss of water (that is not returned to the sewer system).
WHEREAS, a cooling tower is part of an air conditioning system that allows heat from
the air conditioning system to transfer to potable water as it flushes around the compressor coils,
which process use up large quantities of potable water; and
WHEREAS, to accommodate the proposed reduction meter, the Owner must provide
access to the property for the District to install the meter, read the meter monthly for its
registered water consumption, inspect the meter monthly, and provide maintenance as needed.
THE PARTIES AGREE AS FOLLOWS:
1. The above recitals are true and correct and are incorporated herein.
2. Owner hereby grants to the District right of entry onto the property for access to read,
inspect and maintain the meter.
3. Each month the District shall take a usage reading and inspect the meter, and shall
perform periodic maintenance as needed.
4. The meter will be installed until a pre- approved method of installation is agreed to in
writing by District and Owner.
5. Owner hereby agrees to indemnify and hold harmless the District, its elected and
appointed officers, employees and/or agents from all claims and suits whatsoever for
damages to property and/or injuries to persons, including death, and all judgments, court
costs, attorney fees and all other related' expenses arising out of or relating to the cooling
tower, installation of the reduction meter, and readings, inspections and maintenance.
6. The meter will continue to be owned by District and a $4.00 surcharge for each deduct
calculation will be applied to Owner's monthly utility bill.
1
AGE IT M
NO.
SEP 1 0 2002
PG. .,Z..
6
All terms covenants and conditions are and s16 C7
7. This Agreement shall run with the land; ,
be binding upon Owner's representatives, successors and assigns.
IN WITNESS WHEREOF, the parties hereto, acting under authority of their respective
authorized offices, have caused this Agreement to be duly executed as of the day and year first
above issued.
ATTEST:
WITNESS
BY:
Type/Print Name of Witness Type/Print Name and Title
ACKNOWLEDGMENT
STATE OF FLORIDA )
COUNTY OF COLLIER)
The foregoing instrument was acknowledged before me this day of
by , as
for
Personally known OR Produced Identification: Type of Identification produced.
Notary Public
My Commission Expires:
Typed, printed or stamped name of Notary Public
COLLIER COUNTY WATER -SEWER DISTRICT
By:
James W. DeLony, P.E., Utilities Administrator
Approved as to form and legal sufficiency:
By: _Tb in C. Palmer, Assistant County Attorney
2
AGE DA ITEM
N0._ try_
S E P 1 0 2002
PG. 3
16 C7
PROCEDURE FOR COOLING TOWER DEDUCT METERS
Purpose of Procedure: To provide a mechanism to evaluate the feasibility of
installation of meters at facilities that utilize cooling towers. Cooling towers work by
taking in large amounts of water, most of which evaporates prior to being returned to the
wastewater collection system. The purpose of the two meters being installed is to
accurately measure the amount of evaporation that is occurring in the cooling tower and
provide a credit for this water that is not being placed into the wastewater collection
system. The deduct meters would measure the amount of water that is being sent to the
cooling tower and the amount of water that is leaving the cooling tower. The difference
in the two meter readings each month will provide the amount of credit towards the sewer
charges imposed on this account.
Procedure:
❑ Customer desiring the installation of the deduct meters on their cooling tower
facilities will make application to the Collier County Water Distribution Section.
The application forms will be available on the County Web Page, and will be
available at Utility Billing/Customer Service located at 2585 South Horseshoe
Drive. Please note that the application form is attached/enclosed.
❑ After a customer has filled out and returned the form to Water Distribution, a site
inspection will be performed to determine the feasibility of the installation. The
facility must be able to handle the placement of two 2" radio read meters, one on
the upstream and one on the downstream side of the cooling tower. The facilities
must be such that the placement of the meters will allow it to be read by the latest
radio technology being employed by Collier County.
❑ After the site inspection is completed, a written estimate of the cost to place the
meters will be forwarded to the Facility Owner for acceptance. The acceptance
package will include an Agreement that must be executed prior to any work being
commenced. The standard Agreement is attached/enclosed.
u Once the two above items are received and executed by Collier County, Water
Distribution employees will do the installation of the meters and will then forward
the meter information to the Utility Department of Finance for set -up of the
meters into the County's billing system. An invoice will be forwarded to the
Facility Owner and upon payment the deduction of the sewer charges for the
monthly utility billing will begin.
C3 Collier County will apply a monthly surcharge for each individual deduct
calculation to the monthly water /sewer utility bill.
AGE A ITEM es, No.
SEP 10 2002
PG.
APPLICATION FOR COOLING TOWER DEDUCT METERS
Facility Name: 16 C7
Facility Address:
(This should be person authorized to execute legal documents for facility.)
Contact Person:
(This should be person able to discuss operation of cooling tower and meet Utility
Representative onsite for inspection.) -
Position:
Phone Number:
Fax Number:
Billing Address:
Size of potable meter:
Cooling Tower Information
Size:
Engineer Estimate of daily demand of water to cooling tower:
Manufacturer:
Location of Cooling Tower within Facility:
Size of upstream line to cooling tower:
Size of downstream line to cooling tower:
To be filled by Utility after site visit:
Date of Site Inspection: Inspector:
Unusual Site Conditions:
Able to complete installation in a satisfactory manner. (Yes or No)
Estimated Labor Costs:
Estimated Material Costs:
Forwarded to Facility Owner:
SEP 1 0 2002
PG.