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MAR 02 2005 3 31PMw, 3200 �Ie <br /> . r yLRSER,]E+TP <br /> 1�„V(F,ty AUiH_IrTICITY OF THIS DOCUMENT VOp MJ IN VJWRAMO dM EPIS.rM 5nG 1':0000THNNG AUTH¢Nl._.,000MENTMIL CHANOECOI-onr9OIAORANGE TO Ye-W.. <br /> L 1 <br /> 1 T7 1 r <br /> Y ° <br /> I <br /> [^a <br /> UST Installation/Retrofitting <br /> k <br /> ! <br /> � _ CrA'1}r lttYVCN.. <br /> n <br /> I <br /> Promasor ID: XX4.141015471 <br /> i Name, <br /> MIKE JONES Date: <br /> 01128/2005 <br /> Address: -- - <br /> <br /> , SSN: <br /> t <br /> IF <br /> EXAMINATION RESULT: PASS <br /> 1 Congmtula!ionsl You have passed the UST InstallationiRetrofitting examination, Your wailet card and cerltfcate $ <br /> p will be forwarded to you by]CC within Six weeks from the last day of the month in which you tested. This certtilleate._. <br /> Is current for two years. <br /> x <br /> It is extremely important that you notify Promissor and ICC of any changes in name and/or address to a,old the`- Y <br /> possibility of your certificate not being received. Please contact Promissor at 800-275-8301 and ICC at <br /> 877.783-3928 with changes to your name and address. There may be an additional fee if acertification Is m' <br /> k reissued due to a misspelled name or Incorrect address. ' e` 'P• <br /> c <br /> T <br /> a2 d i <br /> av R r <br /> r <br /> 1° <br /> i k <br /> 1 <br /> %tr.+`fara ti <br /> 1HOitl ONv1a311LL06 SF3aV a3NtlYU+!'?.1H9 01 NtlV0 VNOUii1H3LA O11V AT1VIlOt'u'.1 UO 100 S30NVH].nr_O�OOeOHOVe 03UOlC0I1TnW VSVHi <br /> - <br />