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PL-02-20-343 Gas Piping Test 1298 NE 95 St
P.S.G PLUMBING SERVICE, INC 3M M W 125 Street - Opa Locke F . 330M Tel_ (305) 7% 71►6+t FAX: CM% - n9-7M Ceti: 305-7M-730A Uir k.: (CFC 11 7 GAS PIPING TESTS AFFIDAVIT R-oz-Z©-SH3 Home-arvner(PLL-ASE PRINTi Address S7-2ccT Cite; r�M 00e s F S l3� Manufacturer of homL (if known) A I C'( sS qna Serai/l /n{tumber of home (if (known) y2- l l f l [J 1. n f CAr b '' `�3 am authorized to Certil o on behalf of � k.7 lthat on d� c/ -2 2 - 2 z2 _ 0 Z7dw a is piping_ sN.Stem w.Li iestt-d as folla%%-N_ l _ Before all appliances wzre Lonnected. at three (3) PSI for a period 4 net le--N than ten (10D minutes without showing anN dre-)p in pn_•ssure: and ?_ After the appliances were connected and the system was pressurized to not less than ten (10) inches nor more than fmirte n 1.14) inches water column and the appliance connections %ere tested for leakage %,Ith soapy- water or bubble solution. no leaks rrere observed. Signature of tester Qther witness A.4aturew Iae-hen a ' a blej: Horneowne Gas Company I&I bnspeocw The (wtinA of this affidavit must be asaiUble for the inspector when the impectlon is made. F622-048- ) i FPDH ay p►pin,-- test_: aaffidaav at h-M