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HomeMy WebLinkAbout2023 Interstate Testing Reports Aug.14.2023 10:53 AM Interstate Testing 7637555365 4145 P 4/ 4 • . Interstate:Testin , ' vii aclow Assembly Test Report Anoka,MN 55303 (RPZ,DCVA,PVB,SPVB,) (763)744.6149: Interstetetesting@tomeaSt.net City: Fro erty/Ownear tnformatlon sroperiy;Nana.. Presb erian Homes Boutwell Landin ) `P>o :Addeieat3: : :.'• ' mop (‘ 1 1?e . .• Norwich Parkwa „.6:-;.1-,_-.)- ) .7 state: 'Zip: Oak Park Hei•hts u e 5 '82 Property,00tad/Phofle# .:. Name: . . Phone: • : . s • . Mi a Mader. 651 275-5012 Property.Or vaerc:A4dress;: :Address` . . 5600 Norwich 'arkwa Oak Park Hel•hts MN 55082 .: sty:' tp: • Zip: Oak Park Heights MN 55082 ria . 'OW ler PbO e# ms ' tams " Phones 1. ` Presb erian Homes Boutwell Landin• 651 275-5012 it a of Assembi . ork.Perfor med . . Test,,... R , .it RD X .T- ,...,..Re•31r......_, 'E :Test_...._, 'e ti,1 , ... Re ..._... 'Tat.-,r—Repair RB____ BackttowAissembi information .Mo :.:. . ... . . . del:. .:Serial.#i..... _ `.S e$ d 3/4" Wilkins. . 975XL 1293783 Boller Make U. location of Assembly: • . =oi er room Backflow Assembly Test Results e of: CheOtyid*;UI . Shut 01!Valve#2 Reuel Valve/' .Cl i... Waive#2 Apse"bl ..:. . Air I let'Velvo RPL open........„ Closed,,,;g-.. Open. Closed X opened at. 2,8 paid ;.Open. . "..Closed X . Pr+onwe.DUt. 7.5 psl$ Dtd,not opee . Open_.-r_ +Qe_....- Open c'estid-_-,... Open Closed"'°. Premiere NM psid . Pni surweCOX: paid PV B .SPYS Op'• Closed. OPancd At--PIO , Open; .. Closed Pressure OHL paid Did eea open Comments; '.PASS. ,... FAIT.,,.--,,,,; Tester's Information `::T eter's.Nan�ei: • Testers Signtuce: : Cettlflraitlori iii Date:. r � Dorm Miller 0 ��� BF065323 08-10-23 / Aug.02.2023 12:17 PM Interstate Testing 7637555365 #4076 P 24/24 . , . . Interstate Tesiin*,LLC P.O.Box 55 Backflow Assembly Test iReport Anoka.t4N.S.S303 IDCVA,PVB,SPVB,) (763)744-6149. intorAatetesdng.compw.net •• • • .Cityt property/Owner Infornmtlon, • . • , . • PrOpeity Nanies ec,a rL:Ltvzf4j BoLitHveiLLa ProPertiAthfrcss; Addr°1% : •••..•—• • •••., ONorwich Parkway C • .' •• • • • • : • • •City: Stale 244 .• • ,Oak Park H.efghts . Mis,t 55082 P.000*Pm.tact/P:10.flitl;• Ham.: ishon . .• . • • • Mike Mader . 651 275-5012 •:Propeity:Oi#40#A00.0si.: Addniim • • : • .••• 5.00 Norwich Parkwa Oak Park Hei.hts MN 55082 • s': •'' • • • • Stntet • zip:• • • • •• • • Oak Park He'.hts MN . 55082 PrO.Iiirtiovittatfilmiltil:.., Nattier. • • " Phonei Presbyterian Homes outwell faii.rlgLL§fazz§zpz2__,..„ T./1.e of Assembly Work performed . . . . . . alt RB .TeSt aLR 1r BaCkflo%v Assembl• Information . . sue:: 2'1 ••make: • „ moth& • • :Stin .#: . • : •: 3/4' , . Wilkins 975XL 1293783 Boller Make Up LocatlatiofAssembly: I.L. Boiler room \. Backflow Assembly Test Results Type of Check Vette#1 ' : ;hut:OftValve.#2 R efvalvé/. . ,' thedellidve•#2.: . • 'At.$0#,Jt s• • • • - litpz • Open Closed_ Open • Closed Opened at ,ps14 open tagged • Priessaik Dirt _ paid Did not open X OpC&• DOA: • Open Closed, __ Open Closed • ' . •: : Probate DM paid Presnure.WiL paid plityvvg.. open Closed . Opened Open Closed • • l'resSure DIM -. paid . pl4notopen. • - . . • .. Comments: • :4).44$ • . • . Tester's.Information • TOteAl Name:: •: • COfiga On* .1. " Date Donn Miller 5F065323 08-01-23 • Aug.02.2023 12:08 PM Interstate Testing 7637555365 #4076 P 11/24 iinter�tiat�e.Testft>�, LLC. P.O.Sox 5S Backflow Assembly Test Report Anoka,,MN 65303 (RPZ,DCVA,PVB,SPVB,) (763)744-6149 0. lnterstatetest n.as nca5tnct Pity: . .. ProQerty/Owner information . Presbyterian Homes y8outwell La Pt op fx �td'dt+ Adak.= :+68917Norwich Parkway . >_17 C :... city: State: Zip: �. Oak Park Heights MN 55082 Pripertycoattact/Pep: : Name Phone: ., :; Mike Mader (651)275-5012 / Pto Awnerr Address,:.,Aadressr `. 5600 Norwich Parkwa Oak P.rk ei.hts MN 55082 or state: Zips Oak Park Hei.hts MN 55082 Pt'Ope[tywfler/1%011:#... Name Annie . . . Presb terian Homes Boutwell Landln' 651 275-5012 Type of Assembly/Work Pe ormecl raiz.'::: " PVB - ' ,$ :. : "DicVA: . Test X Repalr'RB ,, . Tgstt Ryaic_RBTtst.-�-�noir W ._ Test,Repair,,.,_,,,,.RB Backflow Asseuxbl infornlatiof Sipe : °htAli : l0otfel:. 1 S :m i'(rlte . 3/4" Wilkins 975XL 1298714 ' LocatloanofAssembly: . ras `m. as Backflow Assembly Test Results : :.Type of.: :: cbeckvalveot" : shut:ot:Ivohre 2 :: Relef:VOtve/ : CheckVhfveNFA:: 1 : • AirInletValve : RPZ. °R'" Good X Open , Closed X opened at; 2.6 paid Open Closed X PressocaDi% 9.5 psis Dtdtot opsa DCVA: ° Gos+ed Open-. Goosed Open Closed._.__ Pure DM paid , t ensure Dict..-: paid . . PVO/SPVR Openn __.- Closed-....--; ° posed Openednt paid PTe Di% ,padd . nrd not epee Commetitx . . - . . . PASS... . _:FAIL:..._:. :.: Tester's information TOOte ti Name: Tesaer`e.SIgnatarc; . Certification a..: bate:.' : r Donn Miller s �j '' BF065323 08-01-23 r Aug.02.2023 12:09 PM Interstate Testing 7637555365 #4076 P 12/24 Interstate Testing, LLC. . P.O,soxsS • Backflow Assembly Test Report • Anoka,MN S5303 (RPZ,DCVA,PVB,SPV8,) (7.63)744-6149. interstatetest1ngOcomcastnet • • •(1t'Y': • • • Property'/Owner Information. Pro NA . : Presbyterian Homes IBoutwellLandn1 ProperspAd •• A040 ,sic .: 6:7c- . Norwich Parkway alp r .Stas; zip:: Oak Park Hel•hts N 55082 PrK pe?ty'Coglstt/Phone#b : •Namr.' Phone . Mike Mader 651 75-5012 0opertirOr*nars:At ss. Addiri ,5go: h Parkway Park Heights, MN 55082 00 Norwic wa Oak el_ trate: 21p: Oak Park Hel.hts MN . 55082 . P tly!Otitar/Pltooie .: Mum Phone Presb .terlan Homes Boutwell Landln 651 275-5012 Type oiAssembly/Work Performed SPYB . . DCPA .Test X Repair.RB,,.,,,,, Test Repair„, Ra p Test. Repair RA Tett AR_ Backflow Assembl Information . . . ::;Moil:.. `. se ial.#�... y - ` >�Sert►freds • 3/4" , , Wilkins 975XL 1298744 Location ofAssembly: LL. Garage Rm. (West) • • Backflows Assembly Test:Results '.... check Valve alai.:: Valve'#2 •'tteltet:Velvet Check Valve#2 Ass i �r lnl Valve . tun . . Open Closed X_ Open Closed X ,. Opened at 3.8 ,paid Open Gawk:, X ..en on'..DIM 8.5 paid >fldnol open , . DCYA::• .. Ops Closed Closed Op*e awed_..,._r_ Prwsurebilt, psid erenii rs Ditt paid •PVB f SPVB. OPe" Closed_ _ opened of Arad .PressureOUL- _,- paid Opea Closed .Dtdnotopen • Cotntttents: •PASS . . ...FAIL: • Tester's Information .Teeteis.NAtne: Tesue/'s Slgpat;uire; . .� ` Gerdffcattiort:t D,ate;, .• Donn Miller Lt4L v. ✓�Q BF065323 08-01-23