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Homeowner. <br />=,, CITY OF EVERETT <br />PIPING TEST AFFIDAVIT <br />No. M 990� a� <br />The gas pipin� system was tested at /S t osi for a total of aYN'�. .miautes� <br />WITNESSED <br />INSTALLED <br />� � �� <br />(date <br />Please arrange for someone to be present on the date of roquested inspectlon to provide <br />access for the inapector. <br />Hard Copy - Job Site Pink Copy - Contractor White Copy - �nspector <br />