HomeMy WebLinkAbout2012-08-22 Backflow Preventor (RPZ) Test Report - Boiler Room - Outside Garbage Area - Garbage Rinse 2012-08-23 13:56 INTERSTATE TESTING 7637555365» P 10/13
Cross Connection Control Device Performance Test
interstate Testing
2144 144st Ave. NW.
Andover fir. 55304
Phone (783) 744 -8149
OWNER INFORMATION _ _______,
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FACILITY INFORMATION
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Assembly / N. , /
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Slz 3/v° Assembly Type OAP— 0 RP Detector 0 DC 0 DC Detector 0 PV9P3V13
• INITIAL TEST
gM __@pflt ti9ht O Dld not open
PSID
0 Leaked 0 Leaked
$mac PSID Static a PSID
0 Closetight C Closed tight PSID Opened at PSID
Static MD Static
DETECTOR BYPASS ASSEMBLY IINMAL TEST
EERI
U Closed tight gilt aght Opened PSID
Cloaked 0 Leaked O Did not open
Static PSID Sank PSID
DETECTOR BYPASS ASSEMBLY FINAL MST
Cooed � PSID
0 Closed tight
Static PSID Static PSID
PRESSURE VACUUM WREAKER IMTW. TEST PRESSURE r« UM BREAKER FINAL TUT
atkatilitEl 4. � i Atigalatia
Cpe PSID light Opened et PSID O bsed tight 12 o+ti open Stalk PSC
Static PSID '
COMMHriTB _
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HEREBY CERTIFY THE TEST RESULTS ARE TRUE AND THE TEST WAS CONDUCTED EY ME PERSONALLY.
Tester Nerve (print) ! lE, i1 in ,1 }e - Registration No. o "s323 67 Time of Day
Tester Signature C ..... 0 et. P / k —_ i Phone No. 7 0 1 Serve 4 i sty Date PI 0 i :47. —