HomeMy WebLinkAbout2022 Interstate Testing Reports Aug.08.2022 09:57 AM Interstate Testing 7637555365 #2048 P 8/19
.
interstate Testing,LLC
PA.Box ss Backflow Assembly 'fest.Report
Anoka,MN SS303 (RPZ,DCVA,PVB,SPVB,)
(763)744.6149
tnterstatetesttng@comcastatet City.
PnnpertyName: -
Property/0.wner information
Presb terian Homes Boutwell Landin
Prtrpacty Addie
Norwich Parkwa C�
cur State Zip
Oak Park Hei hts 55082
Property:CDntatt/Phone#• Nome: Phones
Mike Mader 651 275-5015
Property OwiterS Address: AMdres
5600 Norwich Parkway Oak Park Heights, MN 55082 „
City State Zip:
Oak Park Hei•hts M 55082
Prdpert Owner/ppoae# Name: Phone:
Presb erian Homes Boutwell Landin 65 75-5015
T s e of Assembly/Work Performed
RPZ VB SPV>g DCVA
Test X Ir T t R Ir RB Test r. )RB Test._.__:Acpatr its
Backflow Assembly Information
Make• Modell tial#;:
Size: iatii Serr►ioed:
3/4" Wilkins 975XL 1293783 Boiler Make Up
Location of Assembly: L. ®oier room
Backflow Assembly Test Results
Type at Check Valve#1 Stuat OB Vally a#2 ` Relief Valve/ Chuck Valve#2
Assembl Air.inlet Valve
an ` Open Closed '- Open closed X Opened at ,0 paid Open Closed X
pressury owa99.44 psid Did not open
Opon Qawd__--__
�e�/;A. Open_.__ Closed Open.,, Cloned
PressureDJR paid
Pressure DItC _ .__ paid
PVB/SPVB Open Cloaeed Opened at, . pstd
Open .Closed;,_,,,,,
Pressure DIM.-„� paid Old not open
CommttentS:
P.ASSt?AILy,,, ,
Tester's Information
TTst es Name; Tester's Signature: Certification it: Date
Donn Miller • !" BF065323 08-02-22
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Aug.08.2022 09:56 AM Interstate Testing 7637555365 #2048 P 7/19
Interstate Testing,LLC '
P.O Box 55 Backflow Assembly Test Report
AfOka.MN 55303 (RPZ, DCVA,PVB,SPVB,)
(763)744-6149.
tnientatetesting condcast:net 'ItY=
Property Owner Information
Property Name Presb terian Homes Boutwell Landin )
pn►paesiy A¢dresst
Norwich Parkwa b C
CRyt state ztpn
Oak Park Heights 5 082
NI/Petty Conteet/PhoneUt Name: Phone:
Mike Mader (651)275-5015
Preperty..O aers Address:.. .:Addrr x
• 5.00 Norwich Parkwa Oak Park Hel•hts MN 55082
b. State: Zip:
Oak Park Heights _ MN 55082
Property Orwer/Phone ik Ranier. Prone:
Presb erian Homes BoutweH Landin 651 2 5-5015
T e of AssembI /Work Performed
ipx • Pvs. ATO ncvA
est X R B T t Re air RB ost R r RB Test,w.,_..R
Backflow Assembly Information
Slze: Mate • Model $ervlced;
3/4" Wilkins 975XL 1298744
Location of Assembly: Garbage Rm. u
Backflow Assembly Test Results
'type of Check Valve HI • Shut Off Valve#Z Relief Valvef Check Valve#2
As etnbk^ Air InletValve
RPZ Open_- Closed--�-- Open closed_., (�_ Opened at Z.0 paid off.._......Closed__.X...
pressure p m,8.8 psid Did not open,
.
OCVA Ope Ck Open___:;__ Closed Open,;,,;,_. Gored ,
Pressure DM. psid. P'raseu[e DIR _ psld
Pv'ispV$ Open Closed Opened at-.POI
Open Closed
Pressure DIIL psie Did not open
Comments;
PASS FAIL.
Tester's information
'Tester's Signature: Certifcation.a
�'estvetr'�Natrie: gaa pate:
Donn Miller OFBF065323 08-02-22
Aug.08.2022 09:55 AM Interstate Testing 7637555365 #2098 P 5/19
•
Interstate Testing,LLC
P.O.Box ssaclov Assembly Test Report
Anoka,MN 5$303 (RPZ,.DCVA,PVB,SPVB,)
(763)7446149
fnterstatetestingtEcoatcastnet '_ttj:
PropertyjOwner Information
PropertyNatim< s
Presbyterian Homes (Boutwell Landing) _
property st: • Adder
‘500Norwich Parkway 5 `19 ; .
tt� Statim Zip: a
Oak Park Hel hts 55082
P Contact P.hone$; Name Phone:
Mike Mader 651 275-5015
Property OvAters Addms:;. Ad
5600 Norwich Parkwa Oak Park Hei.hts MN 55082
City. State .. Zip:
Oak Park Hei.hts MN 55082
PropertyOwlner/Phone#i Name: Phone:
Presb Brian Homes Boutwell Landin 651 2 5-5015
Type of Performed.
RP`L PVB SPVB . DVVA
Test X,`Repa.tr RB _ Test , Repair RB Tests R94tr t� ' est;,.,-_Repair RB
T
Backflow Assembly information
Size:. M Modell : r ;
3/4" Wilkins 975XL 1298714
iocadon of Assembly: LL. trash Rm.
Backflow Assembly Test Results
Type of Check Valve fit '. Shut`of'tVatve$2 : Relllei'Vatve/ Check Valve#2
m Atr Inlet Valve
,RPZ Open Closed_ Open Closed X Opened at _ .psid Open Closed• �C
Pressure llIt 9_psid Did not Open
DCVA Open Closed Open. . . . Closed Open Closed _
Pressure.Ol1F old. .• Pressure DOE . . pard
PVBJSPVB : Off" Closed___ Opened at, . . paid
Open dosed .
Pressure DIM paid Did not open_.,_
Comments:
PASS,_ X FALL
Tester's Information
Teeter's Nen* .
Testtcern/toner!*.
r.`�S4g
. a�tut+e; � D►ata:.
Donn Miller / BF065323 08-02-22