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•`. Aim . AMOkAl Cons • MadkPI Cot Lim Wrll MOns • AM1006 E4W OMMn <br />:cts tiom Report <br />Oe <br />spector of Record <br />FAX <br />Flom: B. Evrs McAllidar <br />To: L2AeAf �x • <br />or- Zl= .��� j ke At <br />Fax: 4a- 34 7_--M-23 <br />This fax is to confirm tesdng his been performed at the <br />fouowtng factltty: <br />Facility�L°l�/C/ <br />AddrM : Ve// A7 <br />City, Stec: -,Pv RZI-A <br />Teat Date 1104rital _, Dental K—, Level 1 26) circle one <br />Medteal Gem Oxygm_ , Nitrou9 oxide _. Medical air _, Nitrogen_—, <br />Vacuum. DcnW Ai& , D®tal Vacuum. Otber <br />Test completed <br />yuxtim Report _ or Compl paced per NFPA. <br />If completcd final ropoj;,Wfollow in ecven to ton wOA* days. <br />B. <br />2706 164th Street S.W., Lynm+ood, WA. 98037 <br />(425) 741.IM7 . I.800.736-7o47 • Fax:(425`741.2500 <br />JNt IOILLIN 004rt1LS91 Iva W01 900Z%91/t0 <br />1Z <br />