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Home My WebLink About2018-08-20 Backflow Preventor (RPZ) Test Reports - NAC Mechanical 09/05/2018 no 15t 36 FAX a 002/004 . BACKFLOW PREVENTER TEST REPORT riVy4?_041..4,4 AteVArS JOB=DIMS(INCLUDE ADDRESS&STREET NAME,&DIRECTIONAL),Apt/Unit ft 1. c0374/Ll N/68 (14k Ark_ 0/W.!N CRIc kw-c.h&?:psis,e4iJ ;125-08.1 System Served: eirdpitailli 1d4r,-4.,,,,f0 Manufacturer of Assembly: hJATIS Model SI ek:119 M P Size of Assembly: /" Serlal 3/A645-- Location of Assembly:Floor 11 hi)IP/49Ln— Room pile(cerni Date test was performed: ABWCBCire.R1W14;PCIOCI)404,40S01*-14610FPNWikt,(KtVg',' :,gi'r.n'.57: Check Valve 02 Shutoff Valve 112 Check Valve Ill Pressure Differential Relief Valve Initial Test Closed Tight4 YesDNo Closed Tight Yes EINo ?CI,:Ss es ucl gohrtc.pA:clr VD ssdo Opened at eg Ci• psid Check Valve Ill R.5 psid Describe parts and repairs when needed final Test Closed Tight X Yes No Closed Tight Yes No CPiressesudriethrtopAcrYo:—N0 Opened at u9ii psid Check Valve 111_8,2_psid Check Valve 111. Check Valve 02 Shutoff Valve 112 Initial Test Closed TIghti=lf es No Closed Tight Yes=hiv Closed Tight :Yes No psid psld Describe parts and repairs when needed Closed Tight=les JNo Closed Tight Yes 1=No Final Test Closed Tight l=Vesi=lio psid psid Ale Inlet Valve Check Valve Shutoff tt2 Failed to Opei=lYe4=1 No Closed Tight 0 Yes pho 0 E. initial Test Pressure Drop Across Closed Tight YesNo Opened at psid Check Valve el psid Describe parts and repairs when needed Closed right I=Ves 1=do Closed Tight Yes:_No Final Test Opened at paid Pressure Drop Across Check Valve e1 psid CERTIFICATION:I certify the foregoing information provided by me to be correct and - -•device is functioning with the limits of the standards. Name(Print): 1,1)11PLAW1 Signature: Date:eya/y/ State of MN Certificate Number: 15F0AW 99 09 / 05/2015 WED 15: 36 FAX 2003/ 004 V R1,:clooiclf A hl(:(;titv.ii St-t viol.; BACKFLOW PREVENTER TEST REPORT On , 2A-ck Jk,`wi JOB Pl 6RE (INCLUDE ADDRESS ff, STREET NAME, & DIRECTIONAL), Apt/Unit N VeLto 001374 /V ieP ir c PA44. , 1 L1l PA,k I'1 i 4rc, /1 ,&) O8 2 ,. r•. ,-,,^ .r.r. r• 1 .r Z ,• •7 , .r.. •.t u• Y �.,j. �.- •,T`l• err �,, — t - ..�„ i , 1 , • BACs(FLQW,ASSEMBLY I I�FQ�f�VIA '� N;(A�I'FIT :are;`gegtlled) .; ,�'c.'• ,•....;;�, �.,, .'``� ' ., r' ... `�.. •M r. , `iY! ,. ., .. . _'' - u•'_1 . .. „ .. .. •,4 , ., i. 1 i • , J•Irl lti,'s 1 t,;. •_, � i, ,^� System Served: r, Manufacturer of Assembly: IJA7T3 Model ff 6/9/1.7. Size of Assembly: ! (L" Seriel Location of Assembly: Floor 4 AA Room IS '/l✓I'Odf'Y?Date test was performed:.20//I �,•t ,•. ,r1. �yy.. / •/.�`(::J.•'�D'l 4 ! r' "rr:1Qt' ;r •:,'R:Q1 �, �l'�� `'jt1:Np. -p .^i• 7r }( }1'� ll',. '1. '.d•,.•r��t'f�•:11' �j.MY�7�t.i 1'R$• l •. , �lp(e►Balk j�!fIRrk „ .7_ ,, r,�r•.�•i11F ,,. '1 , �.�`'t '� 'i• r�' •'' }L� �'4t1; 1 , �f•t�•). ..n 1,1 Check Valve N2 Shutoff Valve #2 Check Valve #1 Pressure Differential Relief Valve Closed Tight E Yes❑No Closed Tight LE Yes IINo Closed Tight Orti Yes Quo initial Test Pressure Drop Across Opened at 1`I 4 psid Check Valve #1 V7,( psid Describe parts and repairs when needed Closed Tight _,Yes _No Closed Tight • Yes No Closed Tight Yes No Final Test — Pressure Drop Across Opened at d,21 psid Check Valve #1 `7• tp psid }`i .t � ,,. ). r r' y 'J r1. '.)• 'r: ( ��.. •,' 'i(.• n r r.(p.dl� 'fi��;•�t( 'I' ^S�e�f�i/ ■/, Ms .;,tt t:1 • . •` -_lil�l 'i�$J l,l J. • . .. . . ,1..,�, v � :�4 i ( .•w,ri i ..�.., `t'1� v :tr. 1; /,. ,1 Check Valve M1 Check Valve N2 Shutoff Valve d2 Closed Tight 'es EZINo Closed Tight O Yes 10 Closed Tight Yes No Initial Test psid psid Describe parts and repairs when needed Closed Tight es=No Closed Tight LJ Yes t=1‘lo Closed Tight (;;;:i Yes(=No Final Test psid psid '�`r; , res .ter �':�1 �Uurn;�.►1+ 1 !Ors T1s .e f Hill. RV8)1.' r:S il�t.' sus �h�; �l�` um'•� a ke'filt,00 :7T 5I Ft:0.00S Air Inlet Valve Check Valve Shutoff It2 � E Failed to Ope1YeNo Closed Tight Yes ori Initial Test Pressure Drop Across Closed Tight Yes❑,No Opened at T psid Check Valve 41 _ psid Describe parts and repairs when needed Closed Tight E -Hes 1=110 Closed Tight El Yes0No Final Test Opened at psid Pressure Drop Across Check Valve#1 psid CERTIFICATION: I certify the foregoing Information provided by me to be correct and tha • • - • • , • Ice Is functioning with the limits of the standards. Name (Print): 1A31 [I, A •KLAAT 'Sr Signature: ii,r�%� - Date: ? l State of MN Certificate Number: P8F ORgIS 9 09/05/2018 WED 1536 FAX 2004/004 :,1(33WIr:aj 3 RAI BACKFLOW PREVENTER TEST REPORT JQIit4Rg(INCLUiDieDDRELSS ,&DIRECTIONAL),Apt/Unit if 0)„840. c9374/21/ j11/03 Chtk Aiyk. 1Vci M O&LPhrk Y4rc,M&) (525ni3 .". System Served:,11406/./t1A-ItE.Lep ititrX1/ Manufacturer of Assembly: ivivzs Model as off)/143._ Size of Assembly: 314 h Serial# alase-in Location of Assembly: Floork b3F Room iffUeefe10171 Date test was performed: eyiyie 0440 piiii#4.000001,'e.,000.0;0?Ric:046.4r(ROI44t$17)00-og Check Valve#2 Shutoff Valve 112 Check Valve#1 Pressure Differential Relief Valve Closed Tight VA Yes No Closed Tight ca:Yes EINo Pressure drTelghtYes Jo Initial Test Drop Across Opened at c2./0 psid Check Valve 41.,22,2_psid Describe parts and repairs when needed Closed Tight _1(Yes No Closed Tight k Yes_No Closed Tight Yes_No Pressure Drop Aci2iss— Final Test Opened at_aq,j psid Check Valve#3. psid Check Valve 111 Check Valve 52 Shutoff Valve#2 Closed Tight r"---kes f=No Closed Tight I C=No Closed Tight 7 Yes ON° Initial Test psid psld Describe parts and repairs when needed Final Test Closed TIght=res No Closed Tight =yes=No Closed Tight L=Yes=INo psid psid Air Inlet Value Check Valve Shutoff#2 Failed to Ope=YeE:i No Closed Tight 1=1 Yes plc Closed Tight QYeCNo Initial Test Pressure Drop Across Opened at .psid Check Valve 41 psid Describe parts and repairs when needed Closed Tight =Nes CNo El Closed Tight ELVeaNc, Final Test Opened at psid Pressure Drop Across Check Valve 41 psid CERTIFICATION:I certify the foregoing Information provided by me to be correct and that the device is functioning with the limits of the standards. Name(Print):Lai LAN\ l\WIT7 cv Signature: • Date: ell.,70 State of MN Certificate Number: OFOR gin