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Yes 0 No <br /> Informed owner of inspection and testing results and all system deficiencies? I. Yes 0 No <br /> By checking here you are certifying, under penalty of perjury,that you are a valid agent of your company representing that the <br /> company maintains all the necessary licenses and/or certifications to perform this service for this system in this jurisdiction AND <br /> (� THAT the company has properly inspected this system consistent with state and local standards AND THAT the system has been <br /> properly tagged or labeled and the property owner or responsible person has been notified of the inspection results,the system <br /> status,and any corrective actions. <br /> • AUTHORITY SYSTEM INFORMATION ` <br /> AUTHORITY REVIEWREPORT COMMENTS <br />