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HomeMy WebLinkAbout2023-04-25 Commercial Plumbing & Heating RPZ Test Report 22-170P 0Fore74492 24428 Greenway Avenue �i©MMERMIAL st Lake, MN 55025 111 s�«wearNrr,S b NEwT1N6 (651)464-2988 REGULATED BACKFLOW ASSEMBLY (RBA)TEST REPORT NAME OF BUILDING,OWNER/OCCUPANT CONTACT NAME AND PHONE NUMBER St. Croix Car Wash ADDRESS 14455 60th St. N. Oak Park Heights MNE 168f APPLICANT COMPANY NAME CONTRACTOR LICENSE# CONTACT NAME AND PHONE NUMBER Commercial Plumbing&Heating,Inc. PC643117 Melinda Wisgerhof ADDRESS CITY STATE ZIP CODE EMAIL 24428 Greenway Ave Forest Lake MN 55025 mwisgerhof©cpandh.com TESTER NAME TESTER CERTIFICATION# PHONE Joel Parent BF066231 651-464-2988 TEST EQUIPMENT MANUFACTURER TEST EQUIPMENT MODEL# TEST EQUIPMENT SERIAL# TESTING EQUIPMENT CALIBRATION DATE Midwest Instrument 845-5- 11150354 1/10/23 Static PSI TYPE OF WORK AND FEE INFORMATION(check one) - . Install _Relocate _Remove_Replace and SN#of Replaced Device —Rebuild —Test BACKFLOW ASSEMBLY AIIL INFORMATION '3 f4try Type(check one): /Reduced Pressure Principal or Pressure Principal Fire Protection_Reduced Pressure Detector Fire Protection _Double Check Valve Double Check Detector Fire Protection_Pressure Vacuum Breaker Spill Resistant Pressure Vacuum Breaker Manufacturer: Wilkins Model# 975XL2 Serial# ACL2368 Size: 2" (inches) System Serviced Car WashLocation in bldg. Mech Room Floor# Room# TEST RESULTS: 12 Pass L}Fail (COMPLETE APPLICABLE ASSEMBLY TYPE SECTION LOW Reduced Pressure Principal or Reduced Pressure Detector Fire Protection(RP) TEST RESULTS Pressure Differential Check Valve#2 Shutoff Valve#2 Check Valve#1 Relief Valve Initial Closed Tight_Yes_No Test Closed Tight Yes No Closed Tight_Yes_No Pressure Drop Across Check Valve#1_psid Opened at_psid Final Closed Tight Ves_No Test Closed TightYes_No Closed Tight Yes_No Pressure Drop Across Check Valve#19_°psid Opened at 2_8 psid Double Check Valve or Double Check Detector Fire Protection(DC)7 TEST RESULTS . Check Valve#1 Check Valve#2 Shutoff Valve#2 Initial Test Closed Tight_Yes_No psid Closed Tight_Yes_No psid Closed Tight_Yes_No Final Test Closed Tight_Yes_No psid Closed Tight_Yes_No psid Closed Tight_Yes_No Pressure Vacuum Breaker(PVB)or SDiII Resistant Vacuum Breaker(SRVB)—TEST RESULTS Air Inlet Valve Check Valve Shutoff#2 Initial Test Failed to Open_YES NO Closed Tight YES NO Closed Tight YES NO Opened at psid Pressure Drop Across Check Valve#1 Final Test Opened at psid Closed Tight YES NO Closed Tight YES NO Pressure Drop Across Check Valve#1 Describe parts and repairs when needed: CERTIFICATION:I hereby certify the foregoing information provided by me to be correct and that the tested device is functioning in compliance with State of Minnesota Plumbing Code,Chapter 4714. ATESTER'S SIGNATURE: ee PaA.X.s - TEST DATE: 4/25/23