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<br />DISTRICT: 1565 <br /> <br />S E R V ICE <br /> <br />W 0 R K 0 R D E R <br /> <br />PAGE:' 1 <br /> <br />DATE: 07/27/01 <br />TECHNICIAN: BODIE <br />ASST. TECH: <br />PRIORITY: 1 <br />SCHED TIME: AM <br /> <br />CUST: <br />SUB: <br />ZONE: <br />LOCN: <br /> <br />0125112 <br />001 <br />903 <br />0035 <br /> <br />NAME: <br />ADDR 1: <br />ADDR 2: <br />CITY/STATE: <br />ZIP/PHONE: <br /> <br />TEN BRINK CONSTRUCT I <br />5131 22ND ST <br />DOUGLAS RESIDENCE <br />ZEPHYRHILLS FL <br />33540 (813)782-0678 <br /> <br />LAST GAS CHK: <br />FUEL TYPE: M04 <br />PRICE CD/PRICE: 08 1.980 <br />ACCT BALANCE: 0 . 00 <br />CALL RECVD BY: AC <br /> <br />SERVICE ACTIVITY <br />04 MISCELLANEOUS <br /> <br />EQUIPMENT TYPE <br />o OTHER <br /> <br />COMMENTS: ROUGH IN FOR FIRE PLACE <br /> <br />DATE: <br /> <br />7-':;'?~Oj <br /> <br />BILLABLE SERVICE: <br /> <br />(Y/N) <br /> <br />TECHNICIAN: <br /> <br />~.--;- <br /> <br />NON-BILL CODE: <br /> <br />ASST. TECH: <br /> <br />-- <br />/..J <br /> <br />MERCHANDISE INVOICE NO: <br /> <br />DEPART TIME: <br /> <br />(0: ~o <br />it ~ lfS" <br /> <br />PERFORMED (Y/N): SYSTEM TEST <br />SAFETY CONDITION CODE: <br /> <br />GASCHK <br /> <br />ARRIVE TIME: <br /> <br />TNK PCT: <br /> <br />RESCHEDULE CODE: <br /> <br />COMMENTS / NOTES / APPLIANCE INFORMATION <br />J<" Ur 11 - /;'; Fe R.. G=A?i 1/ ti- -I. j:> <br />, <br /> <br />SERVICE WORK PERFORMED <br />ACT/EQUIP CODE ACTUAL TIME <br /> <br />/Vb <br />1lJ~ <br /> <br />~t!1/VJ11 r - JU ~ <br />If:> . <br />F-.6U"# --/A-J <br />/ <br /> <br />Tn? <br />( <br />J/t!T <br />/ <br /> <br />//)o <br /> <br />F.p. <br />(I <br /> <br />SINGLE STAGE INTEGRAL <br />LEAK TEST (3 Kin) <br />SUB PRESSURE TEST (10 Min) ___ <br /> <br />SYSTEM TESTS <br />TWO STAGE THREE STAGE <br />--YRESSURE TEST (IOMin) OPERATING TEST <br /> <br /> START FINISH START FINISH <br /> EQUIP USED EQUIP USED EQUIP USED <br />1st TIME TIME WC/PSI FLOW <br />STAGE WC/PSI WC/PSI LOCKUP <br /> EQUIP USED EQUIP USED EQUIP USED <br />2nd TIME TIME WC/PSI FLOW <br />STAGE WC/PSI WC/PSI LOCKUP <br /> EQUIP USED EQUIP USED EQUIP USED <br />3rd TIME TIME WC/PSI FLOW <br />STAGE WC/PSI WC/PSI LOCKUP <br /> <br />-------------------------- <br />---------------------------------------------------------------------------------------------------------- <br /> <br />The undersigned: - Knows how to turn off the propane gas supply valve in case of emergency. <br />- Have received the consumer safety information and material. <br />- Has smelled propane and detect its odor. <br />- Understands the service that has been performed. CUSTOMER <br />- Has read and understands the above statements. SIGNATURE <br />