HomeMy WebLinkAbout2013-08-29 Backflow Preventor (RPZ) Test Report - Boiler Room - Boiler Make Up 2013-09-04 11:59 INTERSTATE TESTING 7637555365» P 10/13
Cross Connection Control Device Performance Test
Interstate Testing
2140 141st Ave. NW.
Andover Mn. 66304
Phone (763)7444149
OWNER IfNFORMATIQ1d _,�
Ovine Name . . ..... ..-... Street Atttteea
r A, . Ate_ •.. c 1'yi,.e
it tate A' Coda Owra s Cooled Person "sleptsore Number .. .
Cr/ n-, Ahn l y rc.f ( 6c /1 7, C ti 1.�
FACILITY INFORMATION
Nifty t f l� n . , Wrest c j1/4-/01-511 hit,1c,t)2
City ----'-bp Cede Caine/
0 A le Lazifr-1/ )1/414,/c A .i-. .,. _
B 7 Af 7 '-‘ / 4 ' .(I n t -e °^ 'c n'i /3€/ e^ frIA K e-A Y/"
Manufacturer tors!
)•-/ i I -I S 7 7 c
!Y C- _ /65'066 Cr
Size 3/y '' Assembly Type ❑RP Detector ❑ DC ❑ DC Detector ❑ PV SV
INITIAL TEST
at
it: •. . 1ght i.' -.. .•tight at --� PSID 0 Leaked
Static ', ' U PSID Static 11 c PSID
#'MAR:iesT
❑Closed egtg ❑Closed tight Opened at PSID
Static PSID Static PSI D
DETECTOR BYPASS ASSEMBLY INITIAL TEST
L.
9T tact RP relief valve
O at PSiD D I. ed ❑LL Drid
not open
Static PSID Static PSID
DETECTOR BYPASS ASSEMBLY FINAL TEST
❑Closed tight ❑Closed tight Opened at PSID
Static PSID Static PSID
PRESSURE VACUUM BREAKER INITIAL TEST ' PRESSURE VACUUM BREAKER FINAL its,
Nr Inlet valve Ikll__. c iAk EIN vM re
ri ed at p51p Leaked d MINI tapered at P510 Static dlhht �
CI t]id mot open
Static PSID
COMMENTS r----
i/1,_i- -1.474 ).. /e47---
I HEREBY CERTIFY THE TEST RESULTS ARE TRUE AND THE TEST WAS CONOUCTEQ BY ME PERSONALLY.
Tester Name(print) !J a h *"'t /21 t /1-e Registration No.065.3-23 3 /Time of Day
Taster Signature (9- _.' `-- Phone No.7 4. Date .7 a / /2
74/4//6/ V5