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HomeMy WebLinkAbout2023 Interstate Testing Reports Aug.02.2023 12:12 PM Interstate Testing 7637555365 #4076 P 16/24 " . . ___. , • . Interstate Testing, LLC . Backflow Assembly Test Report P.O.Sok SS Anoka.MN 55303 (RPZ0DCVA,PV13),SPVIL) (763)744-6149 laterstatoktestingecioncastnet ity.: _. • s e —, ' • . PrOperty/Owner Information . .p.e.opoov Name: • : " : Boutwell Landing poile4.:Addreist •:' Adak= - ,,; ., 13575 58th St N, : .. ,. . : :: '... atin • Uinta Zip Oak Park Hel.hts u N 55082 P000.tY,COn*CtRhotie#: Nan* Phonec Mike Mader 651 275-5012 PrerietA*0*60,0114.*St: .Mdreig ,• ' ' . : . 5600 Norwich Parkway Oak Park HeiontsMN 55082 Zip: 110 .0011•01.1 Oak Park Ffei.his MN 55082 rli0140000.000.4 wale' " . . , " Phone:: presb e flan Homes(Boutwell.... ........p __. lz .......aj1)275 5912..........,....................._.... Type ofAssembl ./Work Performed Rpr - - t ... : :ftvs . : ' : .sevic... , :: :. ... ptvA : Test 2c,...Reim*_RD _..... Ttst Repair RB _Test Rev& Rg _ Tets;,...,....Rtpalr—AB_ _ BaCkfloW Assembi Information size: —.'. ..:. :?...___ bio,...# 2.,..x.iii .L..;. ..... : . itt$,.., „......10........Seri cedf. 3/4" . Wilkins 975XL 3027840 Trash Rinse v .111.1111111.1.10.1milm, 1'Likation ofAssembly 'a n - oor, ar•age • ea , . Backflow ASS#Mbl Test Results Thieet.: ::, Check Vakfe 01: ; : : 'WC Off Valve#2 . ' ROO *Wet ' Check Vidve:#2 ..:' . Ato,enb1yt .._...:...,....._. ......."0tif tic• ' .: : '...'.:.., . - ........ . :: . •.Air itoz opon, Closed—2.-. , Open C1oedL.X opened at, 2.5 pad Open Ciosmi. X ' . , pressart mg. 7.0 prAd Did hot open ., . . . ' DCVA:. i: °Pen....— awed— Open—. ..... Closed Open. , „ Closed ': • • Pressor.OffC PAIR Majeure OM psid pyttova:.' °Pao— .43med, Opeged *Pea , Closed PrE4surfi MO.--Pad meant ppen . , Cdmineots: . PAtS '....1L;47-4X•• • Tester's information restii's Name: : : : leiceeeSitnaterei ' .:Cerilikatielie: ' ', Date' . „.. ‘ . . Donn Miller f 1 --fi"----e- -- BF065323 08-01-23 . . . . , , .. Aug.02.2023 12:13 PM Interstate Testing 7637555365 #4076 P 17/24 _ InterstateTesting, 1.1C P.O:Bo*SS Backflow Assembly. Test Report Anoka,MN SS303 (IIPZ,DCVA, (763)7446149 isterstatetestisg@comeastost Lit)'. . Pro#erty/Owner Information Prppelly Nan* ; 7 , Boutwell Landin• • irrotteitymtheit *dare= 13575 58th St. N. • Slaw 2ipt Oak Park Heights VIN 5508? tiOrwertycentsd&honss: Nom ptionei • , Mike Mader 651 275-5012 PtSife.rtY.0.11001;.4e1410SS; Address: : 5600 Norwich Parkway Oak Park HeightsMN 55082 : :• • .• City3 Stite Zipt . : Oak Park Ilei•hts 55082 Piioperiy QviDer •*xis* Names " Presbyterian Homes(Boutwell Landing). (651)275-5012 Type of Assembly/Work Performed. RPZ :.PV.1$ SPVB PCVA Test X Repair Re Test Repair .Ra Test Ite_Pair--RS. TeSt—Repair, — • Backflow Assembly Intorination stzei• M I S.rtal rn OW: : • 1-1/2" Wilkins 975XL 3065467 , irrI9ation Loattioo of Assembly; Lower'Mech Room . . _ Backflow Assembly Test Results Type of Check Valve#1 : -Antint'Vatireft.2 • .0,110.Valvei Check VOve#2 : AssetilbD, : 4 • •: Mk 11314 VAIVIr 02: Ckesed—&-. Opto Closed XOpened:It 32 „psid Oostd X PressuroDitt 10.0 psld Did tog*pin — . DMA. °Pea— 112!"1`"-- Open_ Closed Close& Prattsare ,pski Preissure DJE. _ psld . PVBJSPVB "t” • Opened , ,pia Cooed PresSUre „psid Dld not open 0741E1.16W* PASS LLX;', FAIL • Tester's Information: „ Teateessatnit ' Iiits.stinkoret Certification : bate . _ Donn Miller A BF065323 08-01-23 Aug.02.2023 12:13 PM Interstate Testing 7637555365 #4076 P 18/29 • Interstaie'resting,LLC PM:BOX ss Backflow Assembly Test Report Maks.MN 55303 (RPZ,DCVA,PVB,SPV3,) (763)744-6149. .. interatatetesdng@corncastn,t CY + . Property/Owner Information Prope'ty tlt.riise;: : ' Boutwell Landln9 Property Address; ` eder 135755 5 58th St. N. air state. Zip: Oak Park Hei•hts Li 55082 : r .. te.:P Contact rho ill: Nettie. Phone: . : . . Mike Mader 651 275-5012 Piro Mt 01410..11dd vsa;: :nndret • 5600 Norwich Parkway Oak Park HeicLhts MN 55082 ab state: Zip: Oa Park Hel•hts . MN 55082 p.Petty dwper/P4tone#:'. Name: :Phone: Presbyterian Homes(Boutwell Landin9) (651)275-5012 Type of Assembly/Work Performed , N>ax:. . : :eve • o+cv 're X ate r RB Test K t RB Test Re ik TesY Ir .R1t BackfiowMseniibly Information Sive: Maker:.:: 'Model:. • _ _Siring* Vste d m:S4►�vtcs :: 1-1/2" Wilkins 375XL B082054 Location of Assembly; Lower Boiler Room Backflow AssemblyTest Results Type of :._ , . typ. . Chedc:valve#1: ::ShotOR.Ye1Re#� ' :R041et alive/ Check Valve tit: Ascem .. . Ale ntetV ittri., Open Closed X_ open Closed X Opened at, 3.2 paid ,Opel, coded�X PrestttrrMilt 8,8 psid Old n6t open • DCt"A open.__..,. clamed open . Closes 'Open . nosed Premien OM psid Pressure DHt paid Open closed- p4. PYB�S,�'VH _ opent:d at Prepare Oil/ Olen Gored Pre > Dldnot open Continents: PASS ,Y '1rAi<L . Tester's Information Tester's Name: • Tesper°$`51,gratutae: CeriiAeation Dated Donn Miller X15./ //In✓� BF065323 08-01-23 Aug.02.2023 12:19 PM Interstate Testing 7637555365 #9076 P 19/24 Interstate Teest�iing;Lt.0� � " y P.O.Bo> Backflow ow A mi ly `est Report Anoka,.> N 55303 (RPZ,DCVA,PvB,SPVB,). (763)744-6149 interstatetestlng.Comcastnet Oily; Property/Owner lnfonnat#on Boutwell Landing Pro'p ►Ad s ' : �►ddresc 13575 58th St. cult State: zir Nir j: , . Oak Park Heights . ..... . _mu 55082 PES pe f OfltEt/Phos #: :� ats:. Phone Mike Mader 651 275-5012 POPOV.Address;: Addressr • 5600 Norwich Parkway Oak Park Heights,MN 55082 statee,. bps iOak Park Hei hts M 55082 . . . Phone: 'Frop®rgi QWnetyP�oo�ia+k:.:: Name: 651 275- 012 Presb erian Homes Boutwell Landin _ Type ofAssembly/Woxl .Performed . DCVA: . `est,,X,Repair RS ,., Test Repair RB Test_Repair_RE_ Twit l epis-, RB Backflow Assembly Inforlmation. . Size:: iHake . . :Model, :":Seriai'ir: .'SXstietkOr4ced: ' • 1-1/2" Wilkins 975XL 3065453 ' Locadon of Assembly: ower :cm er oom Backflow AssemblyTest Results : Type o ::: Check:Valpe tit . : , '.shot off.Vailye llZ• ::: 'ROW.Vaflye/' Check ridge N2 .1)....... .a. ..;,,, ,....... ...1ArigletValy . . .. .. Open Cooed X Open Closed .X Opened et 3.0 p.td Open Closed X , r Ptesportfld, 8,0 pstd Old net open AtiIA, ... . °pen ,;-;,,; �aR-A open. ,. closed Open-- awes Pressure uta " paid , Preening D1It : PVB/SPVB., Open Closed-«-- Opeeed at pstd Open Closed PreseareOW. Paid. Did not open . " . i.. Comments; PASS:.::_&:FAIL Tester's Information Testet'saita:tnte :�'e�taer a3lgapre ad : �,CertiticaHom:kCjite:. Donn Miller p/1_2-1,0-... i''' ..-2-e-'-.\---- BF065323 08-01-23 Aug.02.2023 12:16 PM Interstate Testing 7637555365 #4076 P 22/24 lnterotate Testing, Lt.0 P.O..Bet SS. • Backflow Assembly Test Report.. • Anoka,.MN 53303 .(RPZ„DCVA,PVB,SPVU) (763)744.6149: interstatetesdn3@comcastnet City:, • • Property/owner information .:Pero hlapoe: P� Y -outwell Landin. • as�re:� . 13575 58th St. N. . CL . sone. Zlpi ::Oak Park Hal.hts . 55082 • )rati.Ol icORWtt/rOne#: N Plop . Mike Mader S651)275-5012 Pcape r:Owi o .sA44ir,essr Address, • 5600 Norwich Parkwa Oak Park Hei•hts MN 55082 . •Ty: Tile, Oak Park Hsi.hts MN 55082 Pt+opierty.t?welei' btAier�l:i Name: Phone: • . : : Presbyterian Homes SBoutwell Landing)_ (651)275-5012 Type of Assembly/Wank Performed { .Test X Repair RB ,.. .—Repair RBTest Myatt Rt.__ Test.., .Repair,,,. ,:RB_.,,, Backflow Assembl Information •: Stze. ., ... . • :MoQdl; • . ;;m, cacti . • . • S- 3/4" • Wilkins 975XL 3027832 Trash Chute Rinse • LocatlonofAssembly:• ower =un.ry oom Backflow•Assembly Test Results • e of Cbeck Yatt+e#1':': :h Of Valve#x' `<. : Relief%alive/ .:• C)�teck V�11ve X12`:. :: • • <Assembl ,: •. • . • . . Ar lnlotValve . `. • • RPZ . Open closed X ape,. . Clones X •Opened at 2.2 .Paid. Opel Closed..X Piensur Ault:9.0 paid m[d not open; DCVA• oPen Cta�d Open Cloned Open Closed PiesstueDltt . geld '.:Pressure DOE • ps}d pvioispvir. open. Closed Opened at psi4 Preston)OMDeet° Cloned Preston) pfd Old'hot open Cornmeal?' .......w. r--, 'PASS�:X�irAIL Tester's Information • .Teste4s.Name: • Tester's:Signature CcrdticaHon ip: Date:•:. Donn Miller r 8F065323 08-01-23 Aug.02.2023 12:16 PM Interstate Testing 7637555365 #9076 P 23/29 Interstate Testing,tI;C. PO:Boa SS Back ow Assembly Test Report. Anoka,MN 55303. (Rn,DCVA,PVB,SPVB,) (763.}7446149 . interstacetesting@colncatt;net . . C.4-y . Pro Owner. nformation Property Tam Boutwell Landin• p!tipet*A ildr i' :: • ' .Addrisc 13575 58th St. N. ..: ..,: . Oak Park Helohts MN 55082 • Ns►mes. ftkonr: Mike Mader. (651)275-5012 nadrrssc -- >pt�opetty.0'M►tie�Address: - 5 00 Norwich Parkwa Oak Park Hel hts MN 55082 . .: Clgr Stile: Zip: . :Oak Park Heights MN 55082 P'h4per4r:94111.04006#; NaMaz P sb n Homutwell erlaes BoLand(n 651275- 5012 Type o f AssemblyfWork Performed : :R�x .:•Pani .7:. : :.:.:-. .. Sera.:..' • - DCVA • • •• 'rest X ReiaIr_80-- Test Repair R8 , Test tepatr.�.,,i .�,,.. rest,.-..Rc�tair.�,.,_RB____ B*ckflowAssembiy Information 0 shire:: • seri • 3/4" . WIlklns . 975XL 30278966 LocsitlotrofAssembly; oun an `oom, unser s .irs Backflow•Assembly Test Results '... Types of .'. :. ;. eck valine.si:. shit of Valve.#z , :teilef Va> ►el. ... .. checi Y'a #3. •Arise"bi .RPZ .Open..,__, d .X , Open Closed X . Opened at: 2.6 ,.paid :Open Closed: X ., . . PtessineD84 8.5 paid 81d,not open. • DCVA.: . OpOpw Gloved ''—' OPen : Closed Open Closed r-- Fluters DOC . psid ; Pressure nip �phi PVBJSPVB , ° —peq Closed . Opened al: . . psld .,. Opao Closed Pressure out -,-,,_paid . Do not opal Comments: .. . : .,.: Tester's Information Tester's Names` , . > . ?eager'**Signature Certification a>fi :- • .Data: Donn Miller A� [� . '� BF065323 08-01-23