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� PIPL TEBT CERTIF2CATE �"'" <br /> PROJECT BOE�/I1G <br /> � PAOJECT NO. <br /> BUILDINO N0. S�D-3� <br /> �'\ <br /> In�truetion�� Thi� lorm mu�t b� fill�d out for all compl�t�d pip� t��tinq. � <br /> Till in only tho�• ��elion� whlch �pply to th� t��t D�inq �lon�. Mh�r� <br /> �ppropri�t�, the Boeinq R�pr���nt�tiv� mu�t �lqn tb� torm Mior� wosk �t�rt� and <br /> in �11 ca��� mu�t •iqn �� witnt��inq th� t��t. Upon oanpl�tion, eopi�� �A�11 b� <br /> di�tribut�d p�r th� li�t Wlow. /` <br /> Vi�u�l In�p�etion Compl�t�d l�/�AA(�N��L� � � ��tiw <br /> S�f�ty R�vl�w Compl�t�d N// <br /> /ratJn Ihpcwitativ� <br /> Flu�hinq of P1p� Compl�t�d ! V� <br /> Au�tin ape�tatiw <br /> Di�int�ction of N�t�r 8y�t�m Compl�t�d /V/'� <br /> Au�tLi lnperwM�tiv� <br /> •Lin� In[orm�tien SAniT,a�2ti ���E'� <br /> Drawinq No.• '� � <br /> ' Loc�tion '�(, luildinp �/D-2 tL <br /> Portion T��t�d (` ) 1�11 or �`P�rti�l �«< g.e•nc-� L+�c oy �jf <br /> T�st• Infornation <br /> D�t� //� 2/- 9/ Time <br /> T��t Hydro�t�tic ()() Air ( ) Haloo�rbon ( � Oth�r ( ) <br /> T�tt M�di■ (be rpaeifie) <br /> Sp�eific�ilon Pr��sur� /D � f✓Fi1dP6I0 T��t Pr���ure /!D' .t/EAd PSIO <br /> Othez Requirements <br /> T��t A��ult� � <br /> 8t�rtinq Pr���ur� /0 NEA d PSIG <br /> Endinq Pre��ur� f0 'NF!Id PSIO <br /> Te�t Duration �' M�n. <br /> Remarks� <br /> CERTIFICJ�TIONt I� <br /> I eertify th�t th� �bov� inform�tion i� corzaet and th�t th� pip�line � <br /> d��cribad above wa� pr�par�d �nd t��t�d in my pza��no� in �ccordancv with <br /> th� �p�oification indicat abov�. <br /> 61qn�d byj� !� �/'Zhy/ <br /> Contr� toz'� A�pr���nt�tiv� D�t� <br /> ��!l�e�'ry t f/ f li�C�-I* <br /> Cont tor <br /> � '� ���-� /i�z� �f/ <br /> Ta�t Witnanrd by , �� p�y� . <br /> Au Repr�rantativa Dat� <br /> � /.�.nGr- A�2/ei <br /> Botinq Representativ� T-� D�t� <br /> 8Cs Au�tin Proj�et bup�zintend�nt Boeinq Repre�ent�tiv� i <br /> 7�u�tin Quality 11��ur�nc� Enqinaer Bo�iny Qu�lity Control <br /> A013 6/�0/91 REV / �� ''�� [..,:.-1-- � . � �� <br /> �r <br />