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Agency |  |  |  |  | Location of Device |  |  |  |\n| * Name |  |  |  |  | *Company\u003Cbr>Name |  |  |  |\n| *Address |  |  |  |  | *Address |  |  |  |\n| *City,\u003Cbr>State, Zip |  |  |  |  | *City\u003Cbr>State, Zip |  |  |  |\n| Phone |  | ( ) |  |  | *County |  |  |  |\n| *Agent\u003Cbr>Name |  |  |  |  | * Date of\u003Cbr>Repair or\u003Cbr>Placing\u003Cbr>into\u003Cbr>Service |  |  |  |\n| License \\# |  |  |  |  |  |  |  |  |\n| Device Information |  |  |  |  |  |  |  |  |\n| * Device\u003Cbr>ID\u003Cbr>(i.e., pump\u003Cbr>or check\u003Cbr>stand \\#) | * Device Manufacturer |  | * Model\u003Cbr>Number | *Serial\u003Cbr>Number |  | * NTEP CC\u003Cbr>Number\u003Cbr>(device or\u003Cbr>component) |  | Type of Device\u003Cbr>(capacity if applicable) |\n|  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |\n| Remarks: |  |  |  |  |  |  |  |  |\n\n* REQUIRED INFORMATION Reference: California Code of Regulations, Title 4, Division 9, Chapter 4, Section 4085 (a)(2)","cbCaiiv687sSxog3","https://ap.wps.com/l/cbCaiiv687sSxog3","pdf",654362,"English","# Registered Service Agency\n## Device Information\n## Remarks","[{\"question\":\"What information is required about the registered service agency?\",\"answer\":\"The form requires the agency name and address, city/state/ZIP, phone, county, and the agent name.\"},{\"question\":\"Which device details must be recorded?\",\"answer\":\"It requires device ID, device manufacturer, model number, serial number, NTEP CC number (for the device or component), and the type of device (capacity if applicable).\"},{\"question\":\"Where is the date of repair or placing into service recorded?\",\"answer\":\"The date is captured in the device/service section under “Date of Repair or Placing into Service.”\"}]","Placed in Service Report for Commercial Weighing or Measuring Devices | PDF"]