395d Results of Acceptance Test

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U S DEPARTMENT OF AGRICULTURE RURAL UTILITIES SERVICE RESULTS OF EQUIPMENT ACCEPTANCE TESTS				DATE
				BORROWER DESIGNATION
INSTRUCTIONS - Borrower's engineer will prepare 2 copies for each project on completion of the acceptance tests and distribute 1 copy to borrower & I copy to installer				PROJECT
				SELLER
A.	COMPLETE THIS SECTION IF DISCREPANCIES WERE FOUND DURING TESTS.
	1. THE FOLLOWING DISCREPANCIES WERE FOUND AND HAVE BEEN CORRECTED: (List below or on attached sheet)
	2. THE FOLLOWING FOUND DISCREPANCIES HAVE NOT BEEN CORRECTED: (List below or on an attached sheet)
	NAME OF SELLER				NAME OF ENGINEERING COMPANY
By				By
	SIGNATURE OF INSTALLER				SIGNATURE OF ENGINEER
B.	COMPLETE THIS SECTION IF NO DISCREPANCIES WERE FOUND DURING TESTS
	1. THE EQUIPMENT MEETS THE REQUIREMENTS OF THE RUS ACCEPTANCE TESTS:
	NAME OF SELLER				NAME OF ENGINEERING COMPANY
By			By
	SIGNATURE OF INSTALLER				SIGNATURE OF ENGINEER

RUS FORM 395d (Issued )