HomeMy WebLinkAbout2023-09-21 Interstate Testing Backflow Assembly Test Report Sep.25.2023 01:56 PM Interstate Testing 7637555365 #4355 P 2/ 2
Interstate Testing,'LiC
P.O. 5S Backflow Assembly Test Report
Anoka,MN 55303 (RPZ, DCVA),PVBB SPVB,)
(76S)144 6144
tularstatet'esting@camcasu et City* .
Property/Owner Information .
Propertyr,Na sal$:
Bremer Bank Oak Park Hei•hts)
Pei*A'. ` Addrea
5990 Nova Scotia Ave. N.
CITY State: pp;
Oak Park Heights MN 55082
PrOpeity OtintaCt .phohe.i'y Niuue: .. phone;
�Allecia McDonald (651)317-3813
PropOioth Mets A4d itti;F 4(13%4P
. .. 7101.West 78th St. Ste. 00 Mlnneatolis MN 55439
:: air States f p;
Minnea•olis MN 55439
Pki :..
�JJty: eM/PItanaal:. . .Jiame; phone:
__ Frauenshuh Management LL 1651)317-3813 _ _
'e of Assembl /W'o'rk Performed.
z rve sw�na:; DCV
Te$t. X Re air: RB .. Test. Re Ir .RB Test R. r RB TM_RIpalr---...R8
Backflow Asselmbi. information
SLie: .. ::,: :Ma . . . Model: .:., ' . :Sorlal#: : . 6 m Sc i ...:
1-1/4" Watts 009M2 A00110 Irritation
Location ofAsserably,: -isor room
Backflow Assembl Test Results
Type;of Check valve 01 'Shut Ott Valve:02 ` Relief vatic/ Check Valva #x'..: :..
erabl
.. . . . . . .. .: . : Air Inlet Valve . . .
Opts,..,-.._ Closed.,,,21_, Closed. °ported et_ 2.4. pstd Open_Hosea X
. Newsom DM. 9.6 Judd.
Old net:open ,
Dcwi Open.....r.„.Cls ed Open Closed Open.___.. Closed
Pressure M. paid. Pres4uro3llR paid
Open Closed Opened at paid
P Open Closed
PressureDUE paid Old not
open
COM In eats:
PASS ,XFAIL:.._.,_
Tester's Information
Teete a Name .: `Tester's Sig nature Certification ft: Datet.
Donn Miller BF065323 09-21-23