HomeMy WebLinkAbout2013-08-29 Backflow Preventor (RPZ) Test Report -Garbage Room 2013-09-04 11:59 INTERSTATE TESTING 7637555365» P 8/13
Cross Connection Control Device Performance Test
interstate Testing
2140 141st Ave. NW.
Andover Mn.55304
Phone(783)7444149
OWNER INF• •MA 9;
• Name Street Address
, A ^ 1 • adpii„
:' • • •. - Plnap, Tetep&trr Number
0-/ r APn.l free,`} ( bc 1) 77 C c,? c t)
FACILITY INFORMATION
Peet;N11716 \ Street Adtbees
r 241 w t /l L,7 A 1 r► g 5 Li C a ,A),:, Lci_ , pc, r je %.aj .�
C1ty Cede County
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Manufact uer - Serial Number
_ Itl< 1ns 5 , Sxt_ uk) ) a ) 685
Sbm 3j4" Assembly Type PAP-- D RP Detector 0 DC 0 DC Detector 0 PVB/sVB
Mirf W.TEST
ST.:�..�. RP rallef valve
•t.•., , Wht seed NOM �,edat ' Sr PSID
O Leaked 5 0 Leaked <j O Old not open
Static PSID Static PSID
FINAL MST
O Closed light O Closed tight Opened at PS10
Static P810 Static PSID
DETECTOR BYPASS A331911BLY IN AL TEST
LC cal RopPsrrelod t P510
O Leaked O Leaked O Old not open
Static PS10 Static PSID
DETECTOR BYPASS ASSEMBLY FINAL TEST
O Closed tight 0 Closed tight Opened at PSSC
Static PSID Static PS10
PRESSURE VACUUM BREAKER IISIIAL TEST PRESSURE VACUUM BREAKER FINAL TEST
hi __Vaud 0:a.,..... 8' .. iAk kiilY2bei
Opened at PS10 ■Closed light . Opened at PSID U Cioeed tight
OU Old riot op«, N leaked Stoic PSID
Static PSID
COMMENTS ?Le-
I HEREBY CERTIFY THE TEST RESULTS ARE TRUE AND THE TEST WAS CONDUCTED BY ME PERSONALLY.
Teeter Name(print) 7)o ,-, I' i 1 11- i- Registration No.0 to 1.3-2 3 R Tmte of Day
Teeter Signature ` /0■x■1 -�-- .. Phone No.7103---— Data
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