HomeMy WebLinkAbout2012-08-22 Backflow Preventor (RPZ) Test Report - Boiler Room - Boiler Make Up 2012 -08-23 13:55 INTERSTATE TESTING 7637555365»
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Cross Connection Control Device Performance Test
interstate Testing
2140 144et Ave. NW.
Andover Ian. 55304
Phone (783) 7444149
OWNER INFORMATION i
n uerne RANA Address
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—.41.... ip C od. ()saner* Contact Person Telephone Number
1 )-%-% ./% Pin. j "ri^‹ - c e i C °> 77 i P S 5
FACILITY INFORMATION
Fe , Nwno Street Address
/ , ; 7' L I Jo / ?x.1 _ S NSG N.Lti y Pe4
.City y z4 Cede Count/
ei A A'� > L yrincam' _ `, 44 `" ke.c. i $i / /_
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" Sri i re / 7 X' C_ 1 664.p
3 '' Assembly Type Gfal - altPlIesessor 0 De 0 cle Detlitter 0 PVISVl
INITIAL TEST gp reilel valve PSIo
VA `. Cloged tight p ar�d at
0 Leaked p lanked 6 Q Did not open
Static • O PSID Static PSI
MEAL
Closed tight Closed tight Opened at _ PSID
� sd PSiD
Static PSID Static -
DiTECTOR BYPASS ASSBi1BLY INITIAL TEST R
'S P r a PSID
elief � M
Hir ed tight U Cto.ed tight 0 Did not open
Cisetwd PSID
Static PSID Sc. t:d
DETECTOR BYPASS ASSEMBLY FMIAL MST ❑ Closed tight Opened M . PSIG
C Owed tight
Static PSID Static PSID
PRESSURE VACUUM BREAKER MN'i<1AL TEST PRts$URE VACUUM BREAKER FINAL TEST
Alt Inlet valve
PSID Clowd tight
ea at PSID 0 � o Static PSID
Oid wvt tope Static PSID
COMMENTS 3 7 r �.5
HEREBY CERTIFY THE TEST RESULTS ARE TRUE AND THE TEST WAS CONDUC E PERSONALLY.
Tester Herne (print) D Ci l'-) , TY), Il Registration No. Uc, - ? ? Time of Day f
f y /17 L Phone No_ 7 L• 3 2>€5" G, s' Da aster Snture ((T `
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