HomeMy WebLinkAbout2022 Interstate Testing Reports Aug.08.2022 09:54 AM Interstate Testing 7637555365 #2048 P 4/19
Interstate Testing,LLC
P.O.Box 5s Backflow Assembly Test Report
Anoka.,.viN 5$303 (RPZ,DCVA,PVB,SPVB,)
(763)744-6149
intersiatetestingecotrtcastnet City:
Property/Owner Information
Or9aper ►Naete, rPresb erian Homes Boutwell Landing
Property Asa, : A.&n+est
. . orwich Parkwa a '{e
: kr: Zip:
•Oak Park Heights ai L : 55082 .
Property ConCact/Phone#tName: Ph►oget
Mike Mader« .. (651)275-5015
Property Owneis'Address address! ..._,
5600 Norwich Parkway Oak Park Heights, MN 55082 _ .
States Zip:
Oak Park Hei.hts MN 55082
Property:Owner/Phone.#:
Prresbyterian Homes (Boutwell Landing) (651 ),275-5015
Type of Assembly/Work Performed
>l P.VB .01/13
DCVA
Test x.....Re. it . Re ..,... Test,. ... R 'air.,,,....RB ' Test..,.,.,. A' r...,.,. ' : Test_Re! .it RR
Backflow Assembly Information
size.
Mam: Model. Serial* ' Serviced:
3/4" Wilkins 975XL 1191851 Trash Chute Rinse
Location of Assembly: • 'ras `oom
Backflow Assembly Test Results
Type of Check Valve#1 Strut Off Valve.#2 Relief Valve/ Check Valye#2
As tnhly. Air Inlet Valvar
Rpz oven cloud Ops+ Closed__)< Opened at_ 3.8 psid ayes closet[ X
Pressure Olt[ 10,0` psid Did dot open
DCVA OPen. . °used"'"`.. Open Closed Opetl.,_,.... Closed
Pressure OWL Arid . Prima Diff paid
PV$ispvg Open dosed .Opetsedpsld
open Closed
Produce bIt( psid Aid not open
Comments:
, PASS,. `:PA L
Tester's Information
Tester;Name: Tester's Signatures Certifications: Dateet
Donn Miller JV p BF065323 08-02-22
Aug.08.2022 09:54 AM Interstate Testing 7637555365 #2048 P 3/19
Interstate Testing, LLC
P.O.Box SS Backflow Assembly Test Report
Anoka,MN 55303 (RPZ,DCVA,PVR,.$PVB,)
(763)744-6149
1uterstatetesdng@comcastnet. city:
Property/Owner Information.
Property RAMC Presbyterian Homes (Boutwell Landing) _
Prnpect►A+ dreesa: Addr}
A • ', 400 Norwich Parkway `a 1(0
City? State: 7Jp
Oak Park Hel.hts 55082
Property ontuct/Phaiic Name: Phone:
Mike Mader (651)275-5015
Property Owners Addressr•.: Manus:
5.80 Norwich Parkwa Oak Park Hei'hts MN 55082
• City: states, pc
. Oak Park Heights MN 55082
Property Owner/Phone#i Name:
Phone:..
• Presb erian Homes Boutwell Landin 651 275-5015
T. .e.of Assembl /Work Performed
RIZ ` PVB SPVil
-
est X it RB Test R ft RB Test Et it RN. Test;,__ 1r RB,.
Backflow Assembly information
Size:: Make: 'Model: . Serial A S! s_teni Servisiad..1
3/4" Wilkins 975XL 1191850 _ Boiler Make Up
Location of Assembly: Boiler room .
Backflow Assembly'lest Results
>Type of:` Check Valve,01 Shut Of Valve 02 s Relief Valve/ Clink Valve 14
Assemb Air Inlet Valve
RPZ open Closed—IL,- Open Closed_,, ,, ' Opened at 4.0 paid Open_ __.. Oosed X
Pt+essure 010, 9,0 _wild Did not open
DCVA-' Open . Closed Open Closed Open Closed,
Pressure Dia paid Pfeiaaure Diff .. paid
Open . Closed Opened alt
pV$�SS Open Closed
Pressure Dine .. paid Did not open ,
fr comments:
PASS,: X:. PAIL_�.�....
Tester's Information
,1 Al ..
,Testees N ane: Teste?s.Signature: CertdBcedon#: pater
Donn Miller �,,� 0 tv J���r BF065323 08-02-22