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�� CITY OF EVEAETT <br /> , <br /> �'� PIPING TEST AFFIDAVIT <br /> � - <br /> ���;�,�,� -�� < �C�_ �L r>>t_, <br /> ✓� �! - - <br /> _ - � <br /> J ,h A�Idress t�` ��_4 _. _� ���G'�_ _ � __--- Permit No. �� /7���v�� <br /> � T in� re(rigerant line natural Lp / medical gas system (circle one) was tested at �Q psi (or a <br /> f:,tal of _� minutes. , <br /> . , <br /> '�NITNESSED BY ,' • `1z-c ��-- Date i 2 7 - c � <br /> . .jyiF�na ure�-rciij�ant reyues g yas seivir.e��-�--�----- — —T-� - <br /> I�J51 �I Lf D (3ti' ��-� � �� -- Date f. �'� � — <br /> ��;iT � *T:srt �-- <br /> Please arranye lur someone lo be present on the date ol requested inspection to provide access for <br /> the inspection. <br /> ��Ef"RIGERANT CONTAINING PARTS OF THE SYSi[M TNAT IS FIELD[FECTED SHALL BE TESTED FOR LEAK A1 TEST PRESSURES NOT <br /> i i SS 1 HAIJ I FIE I.OWCP OF TH[ DESIGN PRESSUR[S OR THE SETTING OF THE PRESSUR[RELIGF DEVICES. THE DESIGN PRESSURE <br /> r ���i� i� � �r;r, SHALL BE THOS[ L.ISTP.D O�!THF r,ONDENSING UNIT OR COMPRESSOR UNIT NAMEPLAT[ (WAC 51�421 t00) <br /> \ <br /> I{;��,� ��,�,y - ,�nb Site f��nk Copy - Contractor White Copy- Inspector -�1 .� <br /> J <br />