HomeMy WebLinkAbout2021 Interstate Testing RBA Report Aug.18.2021 10:39 AM Interstate Testing 7637555365 #9520 P 2/21
Interstate Testing,LI.0
P.O.Box ss Backflow Assembly Test:Report
Anoka,MN 55303 (RPZ,DCVA.PVB,SPVB,)
(763)7446/49
interstatetcstl:ngecom astnet Cit`: _
•
Property/Owner Information .
.Prapertantez Boutwell II L anding
PropertyA.d Address-I;
5260 Nolan Parkway
City: State: Zip:
Oak Park Hehts MN 55082 ;.
Property toitai/Phone#ir ^Hama. Phone:
Dean Evenson 612 503-7498
FropeKP Owneta:Address: address
,5.00 Norwich Parkwa Oak Park Hei.hts MN 55082
City:.
State Zip
. Oak Park Hei•hts MN 55082
Property' er/Pboue Ot rte; Phone:
Presb Brian Homes Boutwell Landin 65 5-5012
Type of Assembl Work Performed
001 . PV)it tPV0 1)C1►A
Test_Lc Repair, ,. RB Test Repair. RR_ TestRepAir RB.,,.. _ Test—Repatr.......AR,.._._ .
Backflow Assembly Information
•
cad:
3/4" , Wilkins 975XL 1794356 Trash Chute Rinse
Location of Assembly: =. . '. :ui sing, - as room
Backflow Assembly Test Results
?hie of ' . 'Check Valve#1Shot Off Valve$2 Relief Vatve f Ch eckValve#2
Assemb _ Air Inlet Valve
RPZ Open closed _ ape, Closed X Opened at ).5 psid Open .Closed X
Pressure Olt[. 8.0 paid Mint openDCVA ,
°Pen Cloned Opp. . closed open Closed,
Pressure MIL. :pall Pure INA: psid
Open Ciosid .,,_ Opened atm-Old
PIM/VW open dosed
Pressure hitt . paid Old not open
Comments:
PAo5, X... FAIL
Tester's Information
-/esters Name: Tester's SIgasature;' certiftcatlon ; i'Tate:
Donn Miller / f1/VntLBF065323 08-17-21