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s -® <br /> BACKFLOW PREVENTER TEST REPORT <br /> DATE:_ <br /> Site Name: Orono Middle School Job# <br /> Site Address:800 Old Crystal Bay Rd City: Orono Zip Code: 55356 <br /> Contact:John Ostlung Phone#:612.919.1769 <br /> Owner: ISD 278 Orono Schools Phone#: 952.449.8345 <br /> Owner Address: 685 Old Crystal Bay Road City: Orono Zip Code: 55356 <br /> Make/Model of Device: Watts 009 M2QT Size: 2" Serial#: 143091 <br /> Serves What System: Lawn Irrigation Location: Boiler Room <br /> Ck Valve Pres. Dif.Across Pres. Dif.when <br /> Ck Valve#1 #2 #1 Ck relief opens Strainer <br /> Leaked( ) Leaked( None( ) <br /> Test before Repair Close Close PSI PSI Clnd <br /> Describe Repair <br /> Final Test Materials Leaked( Leaked ( Noner(4 <br /> Used Close Close PSIPSI Clnd <br /> CERTIFICATION: <br /> I hereby certify the foregoing data to be correct and that the tested device is functioning within the limits of the <br /> standards. <br /> FIRM NAME: Corval Constructors, Inc. ADDRESS: 1633 Eustis Street St. Paul MN 55108 <br /> BY: ll-/e&., ,c 7�;Jd CERTIFICATION#: U,6 6r�3;'S- PHONE: 651-645-0451 <br /> DATE: 7- Z,2 - ,26,6®2 REMARKS: <br /> ( ) INSTALL (TEST ( )REBUILD ORIGINAL INSTALLATION DATE: 2000 <br /> DATE OF LAST REBUILD: -2996- 76ld <br />