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KRAFT <br />MECHAIIICALL.L.C. <br />2441 VENTURA DRIVE • SUITE 100 <br />WOODBURY, MN 55125 <br />MAIN: 651-773-9000 FAx:651-773-9010 <br />BACKFLOW PREVENTER TEST REPORT <br />Owner �Contact Name6 I� 'one <br />Address oCet'V ad cw6 / 4i lbao <br />I f JnS <br />3?g 6L <br />Install Date <br />Rebuild <br />Due Date <br />Locationl <br />Pcv <br />System <br />Served <br />�jk <br />- - <br />VAL aM <br />kjezf <br />Check Valve #1 <br />Differential P <br />ssure Relief Value <br />Check Valve #2 <br />RP <br />Assembly <br />Leaked /� <br />Closed � 710 <br />Opened at <br />Did <br />psid <br />Leaked_- <br />not open <br />Closed <br />rn <br />g <br />a <br />Lu <br />Final <br />Closed <br />Closed <br />Opened at psid <br />Test <br />reduced ressure <br />Double <br />Check Valve #1 <br />Check Valve #2 <br />Check <br />Leaked <br />Leaked <br />Valve <br />Closed <br />Closed <br />m <br />a <br />LU <br />¢ <br />Closed <br />Final <br />Closed _ <br />Test <br />Pressure <br />Check Valve <br />Did Not Open <br />Air Inlet <br />Vacuum Leaked <br />Breaker <br />Closed <br />Opened At <br />fn¢ <br />a <br />w <br />Final <br />Closed <br />Opened At <br />Test <br />Comments/ Notes: <br />Certified Correct. Signed�L; w� Date Tested. <br />Tested by (Print Name)f� J' _ ' ertification Number <br />Sign and Date tag <br />White - City Yellow - Customer Pink - Office <br />