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American Society of Sanitary Engineering <br /> Reduced Pressure Principle Backflow Preventer (RP) <br /> ASSE Standard #1013 Field Test Report <br /> Owner of Property PINE CORNER PROPERTIES LJ.0 .;, , •;4 <br /> Address 550 Old Crystal Bay Rd N / 7 <br /> City Orono ji tate AN'4 Zip Code 55356 <br /> Occupant of Property(if different from owner) JF1T pill a egrig <br /> Occupant Address 550 Old Crystal Bay Rd N \ f <br /> City Orono �\ .F r Sto$` .= Zip Code 55356 <br /> Manufacturer of Device: Wilkins B3 i Model#: 975XL <br /> Size of Device: 1" Serial#: 2836630 <br /> Location of Assembly and Equipment or System Application: Lawn Sprinkler/Meter Room <br /> Test Equipment: <br /> Manufacturer: Wilkins Model#: TG-3 Serial#: 091010878 <br /> Calibration Date:02/18/2015 <br /> Date test was performed: 5/3/2017 Time test was performed: 9:00 AM Static Line Pressure: <br /> Check Valve#2 Shutoff valve#2 Check Valve#1 Pressure Differential <br /> Relief Valve <br /> Leaking CD <br /> Initial Test Leaking U) Leaking (0) Closed Tight ([0) Opened at psid <br /> Closed Tight ® Closed Tight (D Pressure Drop Across <br /> Check Valve#1 _psid <br /> Describe parts <br /> and repairs <br /> when needed <br /> Leaking ([3 <br /> Leaking J]) Leaking (0) Closed Tight (� <br /> Final Test Closed Tight CD Closed Tight (0) Pressure Drop Across Opened at 3 psid <br /> Check Valve#1 5 psid <br /> Certified Tester(print)Dan Swanson Assembly Final Test <br /> Address 1880-B West Wayzata Blvd Performance <br /> City Long lake State MN Zip 55356 <br /> Phone#: ' IN <br /> • ;73-8793 Pass <br /> License#. PM05c• 3 Certi ation# 28072 Fail <br /> Signature � `i a ; 5/3/2017 <br /> Comments or Recommendations (continue to other side,if needed): <br />