HomeMy WebLinkAbout2022 Interstate Testing Reports Aug.08.2022 10:02 AM Interstate Testing 7637555365 #2048 P 18/19
Interstate Testing, LLC
P.O.Box SS Backflow Assembly `rest.Report
Anoka,MN 55303 (RP2,DCVA,PVB,SIMI)
(763)744.6149
[merstatet asting@coatcastnet Cit`: -
Property/Owner Information
P Nau : .
Boutwell Landin•
Property Addresk ids
5450 Nolan Parkwa
City: Stater Zip;
Oak Park Heights
PrtpertyCon act/Phone#tName: Phone;
Mike Mader ..... :�., (651)275-5015
Property Owners Address::
5.00 Norwich Parkwa Oak Park Hei•hts N 55082
ly Stitt 71pi
Oak Park Hei•hts MN 55082
Props 'rty Owner/Phone:#: Name: Phone:
Presbyterian Homes (Boutwell Landing) (651)275-5015
Type of Assembl Work Performed
Rpz • MI - SPVII. kVA
T X Repair RR _ Test,,,,,,Repair RBTest Repair RB.-,�. . T st.�..._Repair RB„�,,
Backflow Assembly Information
Size: Model; Serial Scrvt.,. .
3/4" Wilkins 975XL 1690679 Chiller Feed
Location of Assembly: B •ui •ing, =o er 'oom
Backflow Assembly Test Results
"type of Check Valve#1 T. Shut Off Valve 02` tteilefValve/ Cheek Wye#2
4stemkly
Rpz open,!„— Closed— . open Closed„X Opened et__.paid Open Closed X .
Pressure OW., 9,0 ,ped Did not open
DCVA: apeh tJosed Open Closed Open Closed_____
Pressure DIM psid 1 Points DlR, paid
PVB/SPVB Open Closed.,-,,_., Opened at paid
y_paid
Open Qoasd
Presmarrt flit6 paid. ,Old not open
Comments<
PASS X FAIL
Tester's Information
Testers Name: • Tester's Slgnattrrc:• Certlifkcation i Datet
•
Donn Miller BF065323 08-02-22
Aug.08.2022 10:02 AM Interstate Testing 7637555365 #2098 P 17/19
Interstate Testing,"LLC
P.O.6ox55 Bia flow Assembly Test teport
Anoka,MN 55303 (RPZ,DCVA,PVB,SPVB,)
(763)744-6149
interstatetesdng@copmcast.net 1ty•
Property Owner Information
Propfrty Name Boutwell Landin•
PrupetsyAddness:" dde+es%
5450 Nolan Parkwa
Clty: Stats Zip.
Oak Park Heights mil 55082 ........,"
Property Conti/PhoneNz Mann: Phone:
Mike Mader 651 275-5015
Property Owners.Address:; Ad
5600 Norwich Parkwa Oak Park Hei•hts MN 55082
City State Zip:
Oak Park Hei•hts MN 55082
PMPerty OM'aer/P,hooue#: ; Name: Phone:
Presb erlan Homes Boutwell Landin 6 1 275-5015
T •e of Assembly/Work Performed,
lid • PVB SP.V0 DCVA
Test,lc Repair RR Test Repair R8 , TestReyair RS . , Tom...._.RTUU.
Backflow Assembly Information
Serial s`stets.
Size: � Ma e: Malel:" , -.�...
3/4" 1 Wilkins 975XL 1690666 Boiler Make Up
Location of Assembly:BSA building,toiler boom
Backflow Assembly Test Results
Type of Check"Valve#1 Shut Off Valve 82 Belief Vaive/. Check Valve#2
Assembly: Air 1filetValve
Rpt, Open Closed_._X._, Open Closed X Opened at 3.4 psld Open Closed
Pressure OM. 7:2 psis Dui not open
DCVA Open cloned Open__,__ Closed Open Closed
(Pressure mu psid .;lire DILL ,peld
P'VB/SPVB open closed Opened at. peed
Open Closed.
Pressure Dift paid Old not open
Comments:
PASS. X. PAIL, ,
Tester's information
- fiester'e Name: Tester's Signature: • Certification*: • :Date:.
Donn Miller r BF065323 08-02-22
_ t�
Aug.08.2022 10:01 A:"1 Interstate Testing 7637555365 #2048 P 16/19
Interstate Testing,LLC
P.O.Box SS Backflow Assembly Test est Report
Anoka,MN 55303 (RPZ,DCV'A,PVB,SPVB,)
(763)7444149
interstatetestlng@com:castnet .1t)'..
Property/Owner Information
Property.Name •
Boutwell Landing
Property Address Addre `" '"
5450 Nolan Parkwa
ttkr State: Zap:
Oak Park Hel•hts 11► 55082 .
Property Contact/1%001k Nem' Phone:
Mike Mader (651)275-5015
Property<Ownecs Address: reeig
5.00 Norwich Parkwa Oak Park Hai.hts MN 55082
CItY:
Slat= Zip:
Oak Park Hei•hts MN 55082
PFopirtY ON►ner/Pbobe:# : Raise: Phone:
Presb .Brian Homes Boutwell Landin 651 2 -5015
T e of Assembly Work Performed
RPZ s►ia . • • sPVe: • n(vA.
est X R8. Test R lr RB Test r Jest RH,,,,,,,,
Backflow Assembly Information
size: ;Make: Model:: : - Sells!.#: SYstemi Serviced:
314" Wilkins 975XL W121089 Garba•e Rinse
LocadonofAssembly: = ui •mg, garage room
Backflow Assembly Test Results
Type of Check'Valve lit .. Shut Off Valve#2 fte'ite(Valve% CheckVatpe#2
: Assembly Air Inlet Vive
Opens Closed Open Closed_ X opened at 3.5 ptid Opeo Closed,-_,x�
Pressure DIM 8.4 psid Old not open,
DCVA open_ Closed. OPenClosed Open Closed
Possum OUT paid Prs3ssute Dill paid
PV$/SPv'8 open,_,, closed Opened et..;...Psla
Open Closed
Pressure OM, _ paid Old sot open
Comments:
PASS E FAIL
Tester's Information
Tester's Name: Tester's Signatures Certiftcation;P Date:
Donn Miller a w BF065323 08-02-22