Last updated: 2/1/2023
Coil Cleaning Record Card
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Description
LIQUOR CONTROL DIVISION This record card is to be kept on permit premises one year from date of last entry, and be available for inspection. Sec. 30-6-A23(e) of the regulations. State of Connecticut Department of Consumer Protection 165 Capitol Avenue Hartford, CT 06106-1630 (860) 713-6210 Any material misrepresentation in the following information will be grounds for revocation of the permit. COIL CLEANING RECORD CARD Permit # Date Cleaned Permittee Name Method Used Street Address Number Cleaned Coils Rods Town or City Signature of Cleaner American LegalNet, Inc. www.FormsWorkFlow.com Date Cleaned Method Used Number Cleaned Coils Rods Signature of Cleaner Date of Inspection Signature of Inspector Remarks American LegalNet, Inc. www.FormsWorkFlow.com
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