517 Results of Acceptance Tests

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information
unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0572-0059. The time required to complete this
information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information.
Expires: XX/XX/20XX
U S DEPARTMENT OF AGRICULTURE
RURAL UTILITIES SERVICE

DATE

-

RESULTS OF ACCEPTANCE TESTS

-

BORROWER DESIGNATION

(Central Office Equipment)

CENTRAL OFFICE
INSTRUCTIONS - Borrower's engineer will prepare 2 copies for each central
office on completion of the acceptance tests and distribute 1 copy to borrower &
MANUFACTURER OF EQUIPMENT
I copy to installer. See RUS Bulletin 1753E-201.

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 DISCREPANCIES WERE FOUND AND HAVE NOT SEEN CORRECTED: (List below or on an attached sheet)

*
CONTRACTOR

By

SIGNATURE OF INSTALLER

BORROWER'S ENGINEER

By

B. COMPLETE THIS SECTION IF NO DISCREPANCIES WERE FOUND DURING TESTS.
1. THE EQUIPMENT MEETS THE REQUIREMENTS OF THE RUS ACCEPTANCE TESTS:

*
CONTRACTOR

By

SIGNATURE OF INSTALLER

BORROWER'S ENGINEER

By

* The Contractor understands that the satisfactory completion of tests as indicated by this form shall not relieve the Contractor of its obligations
contained in the contract.
RUS FORM 517 REV. 9-64