HomeMy WebLinkAbout2021 Interstate Testing RBA Reports Aug.18.2021 10:96 AM Interstate Testing 7637555365 #9520 P 19/21
Interstate Testing,LLC
P.O.Bax SS Backflow.Assembly Test Repair.
Anoka,MN 55303 (RPZ,DCVA,PVB,SPVB,).
(763)744611.49
interstatetesdnggcomcastnet City: .
Prope. Owuer Info rrn�tton
PrName: :Presbyterian Homes(Boutwell Landing
PrraArrty Address: : marl=
%e6-Norwich Parkway 5(pi C
Uty: . . Saha Zip;
Oak Park Heights MN 55082
Property Contact/Phone#i Nome:` _ Meet
Mike Mader 651 275-5012
Property earners Address: Address;
5600 Norwich Parkway Oak Park Heights, MN 55082
Ctty:: .....,._State Zip:
Oak Park Hei.hts MN 55082
Property Owner/pboae:#t Haim Phone:
Presb erian Homes Boutwell Landin 651 27 -5 12
Te of Assembly/Work Performed
RPZ PVB.
Fest.) Repair RB,,,Y,,,,. Test,,,,,„,Reeair RB� . Test Rya's* Etta„ ,.. Test_Repalr_RB—
Barkfl:owAss bly information
Size: • Make: .'Model: Serial 0i . System ria**.•:.
3/4" Wlikins 975XL 1191851 Trash Chute Rinse
Location of Assembly: AI. 'rash Room ""`"' `"`
Bat~jtflow Assembl Test Results
Check'Valve#1 Shirt Off Valve 02 Relief Valve,' Valve#2
Assembly
_ Air`Inlet Valve •
RPZ ' epee— Closed_X— Open Closed X opened et _4.0 ;paid Open; dosed X ,
Pressure UltL. 9.4 paid Did not open
DCVA Open Qosod Open Closed, Open Closed
Pressure DHL paid Pressure Dict paid
PVB/SPira °pap Cioeed Opened et psId
, Open awed.
Pressuro Dur paid Did not open
Comments: yY FAIL
Tester'.s information
Testefs Name teeter's Signature: cert�ification:i: bate:
.
Donn Miller ♦ /" �:...,6,e.,..____ BF065323 08-17-21
Aug.18.2021 10:45 AM Interstate Testing 7637555365 #9520 P 13/21
Interstate TTesting,LLC A +
P.O.Box 55 ; Backflow Assembly Test . Report
Anoka,MN 55303 (RPZ,DCVA,PVB,SPVB,)
(763)744.6149
interstatetestingr ocomrastnet City.
Property :Owner Information
Property Mame;
Presb erian Homes Boutwell Landin.)
Perty AddS
Paco Addce�s:
5.80-Norwich Parkway 5610
l
City: .. State: Z!
Oak Park Heights MN 55082
' Property Name: Pnopa
Mike Mader 651 275-5012
Property Owners Andress: Address:
_ 5600 Norwich Parkway Oak Park Heights, MN 55082 _
-City: stater 7Jp:
Oak Park Hel9hts MN . 55082 • ,
Property owner/Phone#tt Naomi Phone:
Presb Brian Homes Boutwell LandIn 651 275-5 12
t e ofAssembi /Work Performed.
• .,,:RP`L., PY8 .PVA... DCVA
rest.2„c Repair RB,,,,, ._TestRepair Re . Test ;.RepairTY1e,1t8, Test---Repair RB
Backflow Assembly information
Size: . ModeX: . Plat at: : to d�
3/4" Wilkins 975XL 1191850 , Boiler Make Up
Location etAssetubly; Boller room
Backflow Assembly Test Results
Typoof Check VCheek Valve rt Shut Off Valve 02 Seiler/Alice,/ rCheckValye z
Assembly `. Alt inletValve
Rpz Open Closed Vii,. Open .Closed X Opened ae 2,8 pad Open: Closed
Pe'essur4 DIM 8.8 psid Dld not open
•
DCVA Open. Closed Open Closed Open Closed
Pressure Diff paid Pressure DUE psid
PVIVSPVB. Open flooed Opeeeit at....,_...Psid
Open . Closed
Prespire t)ief, „paid Dl d not open _ ,
Comments:
PASS; X ito..
Tester's Information
Tostefs:Name; Tester's Signature: Certification 0 Dare:
Donn Miller
AVA., BF065323 08-17-21