HomeMy WebLinkAbout2021-08-10 Interstate Testing Backflow Assembly Test Reports Aug.15.2021 02:09 PM Interstate Testing 7637555365 #9478 P 2/ 3
Testing,esting, ;LC
P.atee aux 5 Backflow Assembly Test Report
Anoka,MN 5$303 (RIZ,DCVA,PVB,SPVB,)
(763)744-6149
interstetetesdng@comOak Park Heightscastnei Ci ': .
Pro.$erty f Owner Information• .
PrppertyNsgae:. Valvoline#010096
Prtver iv,Addiress::. Addresir
5800 Neal Ave. N.
city State: Zip:
Oak Park Heights mk 55082.
Pr opterty Cont tet/Phonefl: Marne; Phone:
Jason Rodriguez (201) 692-8610
PrapertyOwneteAddress Addre :
105 Main Street Ste.3 Hackensack NJ 07601
City: States "lip: •
Hackensack NJ 07601
•PropertyOWner/Phone#: Name: Phone:
Herita•e Fire Securit 201 692-8610
Type of Assembi /Work Performed
ryB s DCVA
Test X Re air ...,, 'B;...,.._. Test R..air........RB .,...... Test ' _ r.._.....RD Test._.,.Repair RB
Backflow Assembl Information
_Size: Make Model: . Serial#R' : ` S!stem Sertctic do
1". Wilkins 375 A376420 Irrigation
Location of Assentbly:'bownstairs,`by mefer
r .
Backflow Assembly Test Results
Typo of 'Check Valve T: Shut Ott Valve#2• Relief Walve/ Checd(V'altre`#2
� Inlet Assembl Air lnl Valve alve :. •
RPZ Open_ Closed _X Open Clow X Opened at 2.8 paid Open -_ Closed X
Pressure pin'. 9.0 pa Moat open -
Dom . Open Closed Open. Closed) openClosed
Pressure Din. petit ..Pressure Dl$. _psld
PV8/SPV13 .Open Closed Open_._ Closed Openedat, , paid
Pressure DI fC . paid Did net opett
Comments:
PASS, X FAIL .
Tester's Information.
Teepees Name:.: Testees Signature: .Certif#catxt.0.. Dake:
Donn Miller BF065323 08-10-21
Aug.15.2021 02:09 PM Interstate Testing 7637555365 #9978 P 3/ 3
infeotate'Y'estiixtg,11CP.O.Box s Backflow Assembly Test Report
Anoka?MNSSa03 (RPZ,DCVA,PVB,..SPVB,)
(763)744-6149
tnterstratetesdngq comOak Park Heightscastnet ity:
Pro .erty .Owner information
ProPer1y'Name Valvoline#010096
Property.Adrires: ;: Addle=
5800 Neal Ave. N.
ti.ty: State: Zips
Oak Park Rel.hts i . 5182
PropertyContact/Phone#ttrttme phone:
Jason Rodri•uez 201 692-8610
Property Owners Address: *ddrea :
115 Main Street Ste.3 Hackensack NJ 07601
qty Static Zip!
Hackensack NJ . . 07601
PPoPertYOwner/Phone it: Names Phone:
Herita•e Fire Securit 201 6.2-8.10
Typeof.Assembl /Work.Performed
RPZ PIM S DCVA
Test .X, Re.air .......R8:•.•.•... Test ....-.. :.:it •.,.•RB....... Test......... 11, • r ...•.... R8 ...... _ . Test_Repair RB
Backflow Assembly information
Size:: . Make: :Model: . ill:#:;: m Serviced:.
1" Watts 009M2 71136 Domestic
Lacatlon of Assembly; I ownstairs, •y me er
Backflow AssernblyTest Results
Type of Check Valve##L Shtiit Off Valve#2 genet Valve/ CheckValve 02
Assemb►' rAl
`l Valve
' "
RPZ. Open,-�,,,, Ctased Open_,.,,,,,_; Closed X Opened at 2.8.__psid Open Closed x ,
Pressure 0 85 .psid .DW not open,
DCVA
Open. . Closed__ • ova, Closed ..... D} Closed.
Pressure OM.. paid pressure WI. paid
PV$/Spvg'. Open Closed Open Opened at paid
Pressure paid 'Dl4,not Open
Comments;
PAS,. X FAIL
Tester's Information
'regimes Name: Tester's Signature: Certification 0: Date:
Donn Miller • BF065323 08-10-21