HomeMy WebLinkAbout2022-05-05 Harris Backflow Preventer Test ReportBACKFLOW PREVENTER TEST REPORT
HARRIS
909 Montreal Circle
Job Number St. Paul, Minnesota 55102
-4@.1 5 %,1 651.602.6606
1=
Address
4,C `'
City ,.
Lt< 9w
, Zip
�C 6 "
. %W.
,r
�. 1
lel -1i
�
Owner
c L, s i7It,+
'2e t 74
Telephone No. `�
51 _ `i
Date
2 Z ")cy
Make andModel of Device
'y
Size ,gg
a
Serial No.
.
• i k
tri•'
A
Location of Device
'r- y
V jxtiti
Check Valve
#1
Check Valve
N2
Pressure Differential
Across 41
Pressure Differential
when Relief Opens
Strainer
Test Before
Leaked
Ea
Leaked
None
Repair
Closed
Closed
L'
P.S.I.
-
r,� y j P.S.I.
>
Cleaned
Describe
Repair
Leaked
Leaked
Final Test
P.S.I.
P.S.I.
Closed
Closed
Cleaned
Cleaned
Cleaned
i
Comments/Materials Used:
Replaced:
Replaced:
Replaced:
fg
Disc
Disc
Disc:
Spring
Spring
Upper
Guide
Guide
Lower
Pin Retainer
Pin Retainer
Spring
Hinge RetainerHinge
Retainer
Diaphragm:
a
Seat
Seat
Large:
H
Diaphragm
Diaphragm
Upper
¢
Lower
Small
F7 L
Seat:
he
Upper
Lower
Spacer:
Lower
Final Test
Closed Tight
Closed Tight
opened at_Lbs
Reduced Pressure
The above report is certified to be true, Certification Number '�Y U 1 "� Date �'� 5% T --
Initial Test By
Representing
Repaired By Representing
Final Test ByRepresenting
White - City Yellow - Customer
Pink - File
HC -1008