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J Puget Sound Gas Works il <br /> war—-11k ‘ - -----yr - .., <br /> 425-343-5566 <br /> PugetSouridGasWorks@C3-mail.corn <br /> 30326 36th Ave NW, Stanwood,Wa 98292 <br /> Gas Pipe Pressure Test Affidavit <br /> For Cascade Natural Gas Company <br /> Project Address: (:) CAP AP\ <br /> il il 1 tzrivA_ c,-) <br /> f-AA-Vc.t. <br /> This gas line was tested at 15 pounds pressure for twenty minutes to check <br /> for gas leaks. <br /> Gauges were checked thouroughly so pressure will not be <br /> released. <br /> 0 pl This gas line was soap tested to check for gas leaks. <br /> By signature of the gas pipe mechanic, the gas leak test was completed and held test. <br /> • <br /> Gas Pipe Mechanic: '6"i,----4--z..._ (17".e:::( -----, fl---3 --'-' I If <br /> Dat-e <br /> Pressure Test Date: -3 k.-- ("1 <br /> • <br />