PL-04-19-914 DROP TESTProever Gas Corp.
18111 NW 68 AVE UNIT I-105
Hialeah FI, 33015
305- 298 -0193 Cell
305- 331- 2572 Office
Forevergas@live.com
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DROP TEST CERTIFICATION
PERMIT NUMBER:
DATE:
ADDRESS ) O 20 w C 0 3 T CITY M I Qr j• *�iDM5 ZIP 'j 3) 3 r
THIS LETTER IS TO CERTIFY THAT FOREVER GAS CORP. COMPANY PERFORM A DROP TEST TO
CHECK THE WHOLE GAS LINE.THIS DROP TEST HAS A THIRTY DAY WARRANTY FROM THE TESTED
DATE
TYPE OF INSTALLATION: NEW ❑ EXISTING
THIS IS FOR A: ❑ WATER HEATER XGAS GENERATOR.
❑ STOVE/RANGE ❑ OVEN
❑ BARBECUE
❑ DRYER
NATURAL GAS:
i►
SYSTEM PRESSURE FROM METER:
WATER COLUMN: 7
TEST DURATION:
DATE OF TEST: 1 ) 17
❑ POOL HEATER
❑ OTHER
❑ PROPANE GAS:
SYSTEM PRESSURE FROM TANK
WATER COLUMN
FLOW
PSI LOCKUP
TEST DURATION DATE OF TEST:
IF YOU HAVE ANY FURTHER QUESTIONS, PLEASE CALL 305-298-0193
DATE: / ��/ /`� ��;��111i1l1►il►►ryi
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CONTRACTO (QUALIFIER)
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DATE:
SIGNATURE OF NOTARY PPBLIC n'=�a:` �`'`
STATE #: 28379
CC # LPG 28379