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Doc No: AGP-TES-PEP-IVC-005

Installation Report for PE Valves Rev No: 00


Eff Date: 12/20/2021
Project Date:
Client Report No
Contractor PO No
TPIA
GA
City / Town / Village :
Area / Site Location :
Valve Chamber Installation & Commissioning Details

Location of Leak Detection Chamber Construction


Sr. Valve Size Make Valve Number
Installation Test (Ok / Not Ok)

Remarks

Contractor TPIA AG&P


Sign
Name
Date

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