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CITY OF EVERETT <br /> PIPING TEST AFFIDAVIT � <br /> Owner U 1 V ��p '�' ' " <br /> Job Address ���_ �� i}� Permit No. �D ` ��I <br /> � <br /> Th refrigeranl li�e natural / LP / medical gas system (circle one) was tested at �pv psi (or a <br /> total of ��_ minutes. <br /> WITNESSED BY �, f^� Date � ���/" Z��S' <br /> / igna�ure oi occupar questi yas serwce) <br /> INSTALLED BY Dale ��—�jf�zO�S � G���<� <br /> �, r i ,8 riiT(�tjS� � n��y ,� � <br /> Please arrange for someone to be present on the date oi requested inspection lo provide access for <br /> the inspection. <br /> � � � <br /> � PEFRIGBRANT CONTAINING PAHTS OF THE S1'STEtv1 tHAT IS FIELD ER[CTED SHALL�E TESTED FQR LEAK AT TEST PR[SSURES NOT <br /> � L[SS THAN THE LOWER OF THE DESIGN PqESSURES OR THE SETTING OF THE PRESSURE NELIEF OEVICES. TH[ DESIGN PPESSURE <br /> ��, FOFi lESTING SHALL�E TNOSE LISTED ON TMF COND[NSING UNIT OR CORSPRESSOR UNIT NAMEPLAT[ I�YAC 51�42�1108) \ <br /> � � 7Z <br /> Hard Copy —Job 5i+e Pink Copy — Contractor White Copy — Inspector <br />