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Get Gas Meter Piping Pressure Test Verification Affidavit

On. (Building Address / City or Town / Zip Code) Complete All Sections That Apply Blue Card No. Lockable valves and test ports installed / exist at the base of each riser. YES NO (Circle One) Gas Turn-On requested for the following equipment (Specify below): CONTACT INFORMATION FOR IMMEDIATE BUILDING ACCESS : PHONE: RISER LOCATION GAS END USE (e.g. Cooking, Heating, Hot Water, Dryer, etc) METER LOCATION NO. OF APTS Location # 1 Location # 2 Location # 3.

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