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CLEAN REPLACE Opened At PSID DID NOT OPEN CHECK VALVE PART NEW PARTS REPAIRS Held At PSID Leaked Cleaned Repaired TEST AFTER REPAIRS CLOSED TIGHT CLOSED TIGHT Opened At PSID PSID PSID Air Inlet PSID #1 Check PSID Chk Valve PSID Line Pressure PSI Remarks: Tester s Signature Tester No. Tester s Name Printed Tester s Phone # ( Repaired By Tester No. Date Final Test By Tester No. Date Gage Calibration Date / /.

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