HomeMy WebLinkAboutBackflow preventer test report •
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Anr1L3) Testi^;$
Of f?.P,Z, Wife
SA" F Off' PR'V.Nr:.R T. "'T REPORT
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SER TcLEPH01dE N. TE.
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MAKE AND MODEL OF DEVICE S UEr, SERIAL NO.
1 Z &o2.
LOCATION OF DEVICE.. i->tav
CHECK VALVE #1 CHECK VALVE sx PRES. RIP. PRES. DIF. STRAINER
ACROSS 11 Wilf.h RELIEF
CKi♦�J
WORE CLOSED CLOSED a ') CL$D
REPAIR
REPAIR
TEESCLOSED (
USED (34-9-'6(1
ler CERTIFICATION:
I hereby certify the Foregoing data to be correct erd that the tasted device is
• functiOnitl within the limits of the sta +dards,
FIRM RAW ADDRESS.524) -=w.1 41./A. .�,or 1 r•+✓
6Y ,?I "-12 TESTER'S CERTIFICATION N(? .21=1 TEL. Nt?.M763- -rte
DATE REMARKS
7ZA 150.,25-7—'
Page 2 of 4
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http://www.deltafaucet.com/bath/details/b35961f-ss.html 2/8/2012
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of P.P.!. +4174,ts
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ADDRESS , CITY . ZIP
° ER tEi.EPHou r!o,,. 10ATE: 3.zg- '2_.-
HIAA AND MODEL OF DEVICE SIZEr► SERIN. MD. >�
is1— � _ 2, _..� ...__. _ i
MAT/ON OF DEVICE:
CHECK VALVE 01 CHECK VALVE 02 PRES. 0IF. PRES. DIF. STRA1t ER
all
ACROSS 01 WO RELIEF
cx .. ik. L
E , CLOSED P CLOSED A WM .
MFAYR
N AIR
FDI -LEAKEDj i LE EZ .......,..ps ...,......ps ,
TEST CLOSED 00
USED IMIIIIIIIIIIIN
w CERTIFICATION:
I hereby tertif,1r the foregoing data to be correct and that the tested device is
fincttontn9 wltnin the limits of the standards.
FIRM 11NE .�� v,..►, ,=t-+-_� ADURES552.c)_ yr,'o i- l2--I ZcXr, ..bet,,..f-,1
iY Z- 4416e- TESTER'S CERTIFICATION NQ.T7F,.....,`..`' TEL. SID. ` :3- ,:-.o�
DATE REMARKS