HomeMy WebLinkAbout2022 Interstate Testing Reports Aug.08.2022 09:58 AM Interstate Testing 7637555365 #2048 P 10/19
Interstate Testing,LLC
P.O.Box 55 Backflow Assembly Test Report
Anoka,MN 55303 (RPZ,DCVA,PVB,SPVB,)
(763 :7446149
interstatetesting@comcastnet City=
Property/Owner Information
P -Mme:
� ` Boutwell Landin•
Property Addret13575 58th St. N.
Uty State Zip:
SQak Park Heights . ;55082
Property.Contact/Phonet4 . Name: Phenyl
Mike Mader 651 275-5015
PrupertyOwnersAddress:: Address:
5600 Norwich Parkway Oak Park Height', MN 55082
City States . . Zip:
Oak Park Hei hts N 55082
Property"OwnerfPbofieMama: Phone:
Presb terlan Homes Boutwell Landin 651 2 5-5015
T r e of Assembl Work Performed
an • PVB • SPVtt DCVA
ext R r RB t R r RB Text ir.. Test:. ,Repair,,,,,,,RB
Backflow Assembly Information
site: Maim. ...: Model: Setdal itS m Serviced
1N Watts 919 QT 75972 Washing Machine Fill
Location of Assembly; Laundry Room, behind washing machines
Backflow Assembly Test Results
.• Type of. T Check Valve#1 Shut OB Valve$$Z Relief Valve/` 7 Check Valve#2
Assembly, Air_bil*:Vatve .
:. Open.---;-- Closed °Pen Closed Opened at psid Open Closed
Pressure Dit, psid Did not open
DcvA Opera closed—X—
Open . . Closed_X__ OPen Closed._X.
Pressure Dict. 8.5 paid Pressure Dict 3.2 . paid
Open Closed
PV$�sPVB Open Opened at
Pressure Dili,_..,,, ,.;paid Did not open
Comments;
'NOS . X .P11L_.
Tester's Information
Tester Name:. :`
Toner's Signature: Certification#: Date:
Donn Miller A p BF065323 08-02-22
Aug.08.2022 09:57 AM Interstate Testing 7637555365 #2048 P 9/19
Interstate Testing,LK
p:0.13ox 55 Backflow Assembly Test Report
Anoka,MN 55303 (RPZ,DCV&PVB,SPVB,)
(763)744-6149
interstatetestingecomcastnet City:
Property/Owner Information
Pr'operty,Namei
Bouiwell Landis•
Property Aorta: Address
13575 58th St. N.
city:+ ... .. ci - . .. State Zt ,
P.
Oak Park Heiights IAN ,§p82
PropertyCoutact/Pboneik Name: Phone:
Mike Mader (651)275-5015
Property Owners Addiess , Address: '
5600 Norwich Parkway Oak Park Heights�MN 55Q82
City State: Zip:
Oak Park Heights MN 55082
PCopefty.OWr r/Pboge:#: .. Name: phone:
Presb erian Homes BOutweII Landin 651 275-5015
Type of Assembly/Work Performed.
ppm • � �-v f'I
Test X Repair Re TestRepair RBTest„ gepair. .ABRepaitr—R$_
Backflow Assembl Information
Size: Make: Models .:Sell` #: y'hit./14 ae
1" Watts 919 QT 75963 Washin• Machine Fill
Location of Assembly.: Laun•ry 'oom, a and "as ing lac Ines
Backflow Assembly Test Results
• Type=d a Cbeek Valve#1; 77 Shut Off Valve#2 • Relief Valve/ Check Valve#2
Assembly Af raptet Valve
RPZ Open ; "Closed X Open Closed_. _ Opened at 3.§ paid Open Closed X
Pressure DM 7.4 paid Did notopee.
DCVA. open__ eased Open Closed Open Clean}
Pressers DittF. paid Pressure CHM paid
PV'F3JSPVB` . Open _,.,. Gosod,«..._ Opened at paid
Open Closed
Pyre Diff. paid DW not open_
Comments.
PASS; X PAIL._;
Tester's information
Tester's Name: rester t Signatures • .Certification#: Dare:.
Donn Miller h - p
BF065323 08-02-22
Aug.08.2022 09:56 AM Interstate Testing 7637555365 #2098 P 6/19
•
Interstate Testing,LLC
P.O.BOX 5s Backflow Assembly Test Report
Anoka,MN 55303 (RPZ,.DCVA,PVB,SPVB,)
(763)7446149
Interstatetesting@rontcasLnet City;
Property/Owner Information.
PtePetw.Name: Presb erlan Homes Boutwell Landin•
Property.Address: Ad'rocs
5600 Norwich Parkwa
CYtn State: Zip:
Oak Park Hei.hts ki s 55182
Property Contact/Phone's:• acts. Phone:
Mike Mader 651 275-5015
Property Owt►ert Addre*s' Address:,
5600 Norwich Parkway Oak Park Heights, MN 55082
Stater up:
Oak Park Hei hts 55082
Property owner/phone:#: Name: Phone
Presbyterian Homes Toutwell Landing) (E$J) 275-5015
Type of Assembl /Work Performed.
RPZ. PV8. SPYB. • DCVA
Te,., aReal A!Q;4,,,-,,_Testy_....Re aIIrw,_Re . Test Re ir !�BTest Re?alr ,RB._._.
Backflow Assembly Information
Siege: Make: Model: Serial it System ervloeti:
1" Wilkins 975XL 1327583 Pool Fill
Location of Assembly; Pool fi(I room -
Backflow Assembly Test Results
Type ofCheckValve ltt Shat Off Valie#Z Bell etValtve j. Check V`aloe#2
A. mb)_ Air inlet Valve
8FZ Open.._.,.;_ Closed,_ X Open Closed X Opened et 3,g ps$d Open _.eased..
Pressure Diff..9._psid Did not open.._.,,.
ocvA
Open Closed Open Closed Open Closed
Pressure DUE paid. .Pressure OI paid
PVBJsPVB Open Closed Optpad at pSid
Open Oozed
Pressure Dirt psid Did not open. ,
Comments:
PASS X .PAIL
1,
Tester's Information
Tester's Name: Tester's SignaturecCertifcarton_#: Date.
Donn Miller • int f� BF065323 08-02-22