HomeMy WebLinkAbout2014-08-26 Backflow Preventor (RPZ) Test Report - AL Trash Room - Garbage Chute Rinse Aug.29.2014 10:59 AM Interstate Testing 763 755 5365 PAGE. 2/ 14
Cross Connection Control Device Performance Test
Interstate Testing
2140 141st Ave. NW.
Andover Mn. 66304
Phone(763)7444149
116,ULI
661/0 J\10-wi1/4f-P . rj
OWNER INFORMATION _ _____.
Owner Name ...-Slrest Askiltess
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IL NFORmATION
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FACITY I
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Assembly Locabes ) 1 fl
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INITIAL •T
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PSID
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Steno PS10 PSID
RilMtLiEST
0 Closed Sant ()Closed tight Opened at P810
Static PSID StatIc PS10
OcTECTOR BYPASS ASSEMBLY INMAL TEST •
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0 Closed tight Cgired tight PSID
4 Leaked 0 Looked atklednoettopen
Static MID Stack P810
DETECTOR BYPASS ASSEMBLY AMU.TEST
0 Closed Ugh* 0 Closed tight Opened at PSID
Static PSID Static PSID
PRESSURE VACUUM BREAMOrk INIfiAL.TEST PRESSURE VACUUM BREMER FINAL TEST
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Static PSID .
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COMMENTS
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I HEREBY CERTIFY THE TEST RESULTS ARE TRUE AND THE TEST WAS CONDUCTED SY ME PERSONALLY.
Tester Name(print) D 0,t1 .-1 PI 1 i j-e_A- Registration No.0 61.3-13 g 7—TIree of Day
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Tester Signature (1.-w*LZ : ___ Phone No.7t3 Date 4,4iv
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