Pressure Test Certification Form

Pressure Test Certification Form

Fill out form after gas piping is complete and tested. Pressure tests, including retest of existing piping, must be completed within 10 days of requested turn-on date. IGU will not turn on a natural gas system in the absence of pressure test results.
Customer Name*
Address*
Jurisdiction*

City of FairbanksCity if North PoleOutside City Limits
Installer Name*
Installer Company*
Test pressure to be used shall be no less than 1 ½ times the proposed maximum working pressure, but not less than 10psig. When testing a system having a volume less than 10ft or a system in a single family dwelling, the test duration shall be not less than 10 minutes. Otherwise, test duration shall include an additional 30 minutes for each additional 500 ft of pipe volume, or fraction thereof. Any reduction of test pressure shall be deemed to indicate the presence of a leak. Testing must be repeated after leaks are repaired.

As a reminder, the customer or their installation contractor needs to inspect piping and appliances for leaks immediately after the gas has been turned on.
Date of pressure test*

MonthDayYear
Date
Pressure (psig)*
Duration*
I hereby certify that this installation has been satisfactorily pressure tested and that it meets all applicable laws, codes, and ordinances.
Installer’s Signature*

Clear
Date

MonthDayYear
Date
Date and time of your turn on
Should be Empty: