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Gas Certification Form Mobile App

The Gas Certification Form mobile app was develop to replace the paper Gas Certification for Piping and Appliances Downstream of the Meter for a New Construction Form. Dispatch allows you to pre-populate GoCanvas apps and then assign them to any users in your account.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Gas Certification Form Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico statictext

    Gas Certification - Piping and Appliances Downstream of the Meter – New Construction

  • Ico statictext

    Note: Gas service will be turned on and activated only after the electric service has been turned...

  • Ico textbox

    Municipal Permit Number:

  • Ico textbox

    O&R Project Number:

  • Ico textbox

    Installer’s Name

  • Ico textbox

    Installer’s Company

  • Ico textbox

    License #

  • Ico textbox

    Phone #

  • Ico statictext

    hereby certifies that all gas piping and appliances installed at:

  • Ico textbox

    Customer Name

  • Ico multiline

    Address

  • Ico date

    A) meet all installation requirements of: 1) the State Fuel Gas Code; 2) the equipment manufactur...

  • Ico decimal

    at a pressure of psi

  • Ico decimal

    for a duration of minutes.

  • Ico date

    (date)

  • Ico multiline

    Remarks:

  • Ico signature

    Installer’s Signature:

  • Ico textbox

    Date:

  • Ico dropdown

    Is Corrugated Stainless Steel Tubing (“CSST”) present?

  • Ico statictext

    If YES, I certify that it has been properly bonded to the grounding electrode system of the build...

  • Ico textbox

    Installer’s Name

  • Ico textbox

    Installer’s Company

  • Ico textbox

    License #

  • Ico textbox

    Phone #

  • Ico multiline

    Remarks:

  • Ico signature

    Installer’s Signature:

  • Ico date

    Date:

  • Ico date

    The undersigned municipal code official inspected this location on

  • ...and More!

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