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PL-09-21-2478 123 NE 99 St
3800 NW 59 St MIAMI, FL 33142 CONFIRMATION OF DROP TEST Date 10/03/22 Permit Number 4-DL -©q- Z ( — ZU TL Address: 123 NE 99ST EQUIPMENT USED: X MANOMETER TIME: START 9:45 AM FINISH 9:48 AM WC: 9.3" 9.3„ I Dmitry Pressman as a Suburban Propane CSC Service Manger for the Miami Division have verified that Segundo Gonzalez a qualified Suburban Propane Service Technician, has completed and documented the above mentioned drop test in accordance with NFPA 54 and Florida Building Code (Fuel Gas). STATE OF FLORIDA, COUNTY OF MIAMI-DADE SignatI� mt urF try �ce ssw�oyt �t Print Name Sworn to and subscribed before me this _y day of G lO444 2022 Signature or Notary Public_ State of Florida Seal: 1'er IK known OR, Produced Identification Pentificsition Produced asp SUBURBAN PROPANE 3800 NW59TH STREET, MIAMI, FL.33142 (305)635-4427 Notary Public State of Fla M Mada E MW My r_Vrwn &0M HH 155843 Eakes 07l270025