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gas piping compliance ' 07/92 • CUSTOMER INSTALLED GAS PIPING COMPLIANCE CERTIFICATE NORTHEAST REGION CUSTOMER NAME M ,6.--tio ADDRESS • Lff CC )- 02...., C ..cam. e.. PHONE The undersigned hereby certifies that the gas piping installation at the above address conforms to the followings • 1 . All piping materials, joining methods and installation procedures are in accordance. with Niagara Mohawk's Gas Constriction Procedures and/or the latest edition of the National Fuel Gas Code. 2. The piping has passed a pressure test conducted in accordance with Niagara Mohawk's testing procedures and/or the latest edition of the National Fuel Gas Code. `x 3 . All gas utilization equipment and appurtenances are AGA certified. • 4. The contractor has provided Niagara Mohawk, at the time of inspection, with a sketch including measurements depicting the location of the underground gas piping. 6°Contractor's Signature: Date: - 7_/3 r/9 . . ., • . . ,,, •:;. , PRESSURE TEST REPORT Service at: y ;2- 6c\61,1.--4-1)—cz � } Tested at: psig - for: <,? (minuThrs Date: S — I — /57 . Company /Name: PP0( D 7W CC Phone Number: `--/ 6 `?LS1 - 0 `f3 Name (Print). • i ?i [C---° LLD (1- 2, • , i!Signature: '__ _