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CITY OF EVERETT <br /> PIPING TEST AFFIDAVIT <br /> � -/ _ _ w�� <br /> ��ti���@� ��� �-. <br /> Job Address ��� � Pennit No. E C�� _� <br /> t-C�h'�STI.:L'-� V�P_ 4�,'� � � S T�l::l�� <br /> The r . was tested at � for a <br /> -t . W ��i� '�. I O` 1�1 l:�i-(� c� F W �1 c:.�� L.L'A-lLs <br /> r <br /> WITNESSEDBY �,p�y�_ �' Dale /�.Z-7/vf� <br /> n�tu o�pant requesung gas servic�- <br /> INSTALLED BY Date � _Z7,� p8 <br /> �� � �a�u� , �, s-rttsr�— <br /> Please arranye (or someone to be present on lhe date o( requested inspection to provide access for <br /> the inspection. <br /> RGI=qIGERANT CO'rJTAINING P:1HTS O�TH[ S1�tiiCt.11H•V IS FIELU ERECTED SHALL�E TESTED FOR LEAK AT TEST PRESSURES NOT <br /> LESS THAN THG Li)lV[H OF lti[ DLSIGN PHESSUHFS OH iHF SGTTING OF THE PRESSURE RELIEF DEVICES. THE DESIGN PRESSURE <br /> � FOR TESTING SHALL l3E TNOSE LISl EU UN r1�1L CO'JUENSING UNIT OR CO�dPRESSOR UNIT NAMEPLATE.(WAC 51-42-1108) <br /> Hard Copy-Job Site Pink Copy - Contractor White Copy- Inspector , �� <br /> ��:� <br />