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� <br />�. <br />�ITY OF EVEFtET'T <br />GAS PIPING TEST A�FID�VIT <br />Homeowner�lJ���1_ Sl�LL — <br />Addreas n D I'-j' �� 6 EU�/L�L �� Pormit No�1�1�a6" Dl{o <br />The gaa i in a stem was tested st J�.psi for a total ot�minutes. <br />P P� 4! Y <br />WITNESSED <br />INSTALLED <br />�a t � <br />.�� D I <br />(date <br />Please arrange for someone to be present on the date of requeated inspection to provide <br />access for the inspector. <br />Hard Copy - Job Site Pink Copy - Contractor White CC+py - Inepector <br />