HomeMy WebLinkAbout2014-08-26 Backflow Preventor (RPZ) Test Report - IL Garbage Room Aug.29. 2014 11:01 AM Interstate Testing 763 755 5365 PAGE. 6/ 14
Cross Connection Control Device Performance Test
interstate Testing
2140 141st Ave.NW.
Andover Mn. 6004
Phone(783)744-6149
OWNER INFORMATION .--- '. 559 o i\fcr\(u) r-irl ?)?iii(j->
r.Name Street Addreee
4 /"CsAy 't;oiol?c) ,-) i) l.e •i
State Zip Code Owes Cowdect Pawn Telephone Number
FAO/Uri INFORMATION
Flifiltif Name Mmothidmu
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ORI 1 Code cifr;d21° .041_ rd4 I' k i-•;".k. ti
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L (--'..el A I? - ._e i , i !At &it' 1 p ( c' .. .4, - _
Model '
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9
INITIAL TEST
atL --
- B111& ght 1 =1ht Opened at J5 .. i? P81D
()Leaked 0 ("S. o uilked 0 Did not open
Static P8(0 Static 0 1C — PSID
SIMAL liiIST
0 Closed tight 0 Closed light Opened at MD
Static ,PSID Static .PSID
DTECTOR BYPASS ASSEMBLY INITIAL TEST
BP-AktEENE
CILTAIDIkeed tight Closed tight at PSID
0 Leaked 0 Leaked gx1Diiir not open
Static MD Static PSID
DETECTOR BYPASS ASSEMBLY FINAL TEST
0 Ciosed tight 0 Closed tight Opened at PSID
Static P810 Static PSID
Pilestste VACUUM BREAKER IA1AL TESi PRESSURE VACUUM BREAICSR FiNAL TEST
Altinktlasta Mt/Skaa Akillittillikil
red MID B Closed tight .Opened at PSID C1081"811"ed tight
a)Deindnor open Static PSID•
StatIc PSID
._
.
COMMENTS
____
_______
I HEREBY CERTIFY THE TEST RESULTS ARE TRUE AND THE TEST WAS CONI__IgMalINIE PERSONALLY.
Tester Name(print) D 4 i'l el ill 1 i be.A. Registration No.0 6 C 3-23 8 rTirne of Day
Teeter Vonature (..20"-"-• "1-4-61 Phone No.76.3 Date Zi_Y.