RC-10-18-3014 DROP TESTOffice: 786-370-4298 • Fax: 305-828-5550
P.O. Box 133219 Hialeah, FL 33013
rrelitegas@aol.com
ELITE GAS CONTRACTOR INC.
DROP TEST INFORMATION
Customer Name: Date
Service Address: Z 9 X/C-- /0 9 5'7'
Licensed & Insured
LIC# LPGO01122
City: State: � Zip: 3 3l6/ Permit # 10L -4S-lf - 12-30
Manometer Pressure Test: Start WC
Lock Up % �w
Load
7 Finish WC 7
Lock Up First Stage
Leak Detector locle
Gas Left On /Ye___� Satisfies Code
Meter #
Reading
Min 1.5—
Lock Up 2nd Stage
Leak Location IV
7 I''_aC
Soap Test YES
�5ri ' Odor Strenght �ydet�l�C
Tank #
Appliances: *7�yctt5 &2�7z-gr �,�, 101
Comments:
Reading
This drop test cover LP I Natural Gas items and equipment visible and accessible to the service
technician and represents the condition existing on the date if inspection. It does not cover latent of
manufacturing defects, the internal working of sealed equipment, or structural components,
and cannot be construed to cover future unforseen happenings.
Service Technician Signature
Master Qualifier Signature: ` J
FRANK E. GAISER
¢;: MY COMMISSION # GG 210960
�f�� ='• -3 EXPIRES: July 23, 2022
Master Qualifier Print Name: ,e! C114 fl <✓�✓�ye-y ''•'Four• BondedThrul4a'.eyPublicUnderwriler• 1
Customer Signature:.'