Exhibit_5-_GSA1034A-76 1 .pdf
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- Attached to
- Facility Maintenance Services -- Z
- Solicitation number
- RRB15R0005
- Issued by
-
Railroad Retirement Board
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Exhibit 5
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ACKNOWLEDGEMENT OF INSPECTION CERTIFICATE PRESSURE VESSELS
CERTIFICATION
I CERTIFY THAT THE ORIGINAL OF THIS CERTIFICATE OF INSPECTION OF PRESSURE VESSELS (GSA FORM 1034) HAS BEEN COUNTER SIGNED BY THE CHIEF OPERATING ENGINEER AND POSTED IN A POSITION ADJACENT TO THE APPLICABLE PRESSURE VESSEL. THE CERTIFICATE ALSO INDICATES THAT THE EQUIPMENT INSPECTED HAS BEEN APPROVED FOR OPERATION AT THE MAXIMUM PRESSURE NOTED.
DATE
GENERAL SERVICES ADMINISTRATION
SIGNATURE OF SUPERINTENDENT
GSA 1034A (REV. 1/1976)
11.0.0.20130303.1.892433.887364
| BUILDING: |
| MAXIMUM PRESSURE PER SQUARE INCH: |
| REGION: |
| CITY: |
| UNIT NUMBER: |
| TYPE OF SERVICE: |
| Date. Enter 2 digit month, 2 digit day and 4 digit year.: |
| SIGNATURE OF SUPERINTENDENT. DIGITAL SIGNATURE: |
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