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HomeMy WebLinkAbout10/11/2021 Backflow preventer testr Modef it se let# 3 5'ta`31/ -3/-, System ServieedL X01 c E>Z ic.c �f She:, _ (Inches} mechanical, contractorsInc, 1257 Marschall Road, P0, Box 237 • Shakopee, MN 85379 Phone;•852/445.5100 Cheek Valva k2 Shutoff Valve N2 Check Valve #11 -FR ressure Differential Pax: 9521415.5119 iVAMEOP 13UILOING, aWNFR/OCCUPANT� CONTACT NAME AND PHONE NUMBER l r<�ai�5 or ClosedTight ,..._Yes—No COMPLETE JOB ADDRESS (INCLUDE Apt/Unit #) Closed 7TIght—Yes ,._.-NoTest APPLICANT CpMPANY NAME pressurss Che;Vatve #1 Opened at psid ._.._psid CONTRACTOR LICENSE tI •CONTACTM1JANIE AND PHNI NUiNBt fi Associated Mecharoicai C®r�tractars L098 22749 ADDRESS CITY ,Charlie R(echer's 952-495:530U Pa Box a37 Shakopee TESTEf; NAME... STATE Zip EMAIL MfV S53i9 crreohers(aassocfatedmechanlcaLcom Dave Muellerleile T1:STER CERTIFICATION # PHONE 754900 - 43711 952. 48-6100 TEST EQUIPMENT MANUFACTURER TEST EQVIPMRNTMODEL # TEStEQUiPMENTSER1At # TE9r1NG EQUJPMSNi CAIIBRgTION DATE Midwest' 845.. r=— -- — _ 843463 _t _ Mn 12 Vs 1 O rev. -... nCNbd CC ,�, nemove _____ rte face and SN# of Re laced Device Rebu(Id OVA Type (check one): � Reduced Pressure Principal or Pressure Principal Fire Protection . vReduc�d Pressure Detector Fire Protection .Double Chill Valve n­ay- y- rh....r, n...-- - ,-- — - -- - •�,��•� ��1,CiDVl�vacuumrreaxer,,,�5pWResistant PresSUreVacuum Breaker Nianufatturer: " K vA%.J %�7SX[ Modef it se let# 3 5'ta`31/ -3/-, System ServieedL X01 c E>Z ic.c �f She:, _ (Inches} Loealil In bldg `�� N Floor q / Room N :'r{{ 9tYinilrilciw I, T e Ia PrBssli Vii' r Inc pa or educe' rasstireeti� „� a "titcilon • � I � T6�T-R� UGiaF. • Cheek Valva k2 Shutoff Valve N2 Check Valve #11 -FR ressure Differential Relief Valve Initial C(osedT(ght „-_ es —No Closedylght �wNo Closed Tight _Yes No Test Opened atpsid Pressure Drop Across Check Valve R3 ` , Opsld Final ClosedTight ,..._Yes—No Closed Tight _Yes _No Closed 7TIght—Yes ,._.-NoTest pressurss Che;Vatve #1 Opened at psid ._.._psid DRpble Check Valve or Double Check Detector Vire Priafiectlati DC —YESr RESULTS Check Check Valve #ti Check Valve #Z Shutoff Valve 62 _,Yes No psld C(osedT(ght _•, Yes No psid Closed T)ght _Yes No PFInal �No ,-, CiosedTlght —Yes —No _Tpsid Closed Tight _ Yes std P Closed Tight ,•._Yes No Pressure Vacuum breaker PVB or Spill Resistant ltacuurrl Breaker (SRVBj —7>:ST RESULTS Air (I Valve Check Valve shutoff #2 Initial Test Failed to open _.,.Yes _ _No Closed Tight _Yes —No 0 erred at psid Pressure Drop Across Check Valve 41 psid Closed TI$ht „Yes _,••, No Final Test Closed Tight _Yes No Opened at . psid Check Pressure prop Across Valve #1 sid Closed Tight _Yes, No describe parts and repairs when needed: Ct3RTIF1CA71ONt l hereby certify the foregoing Information provided by met torr of s twi thetas ed d sfunctloning in complio ce with State of Minnesota Plum�ingCode, Chapter 473A. • resrER'ssIGNATlIRIi- _ _ �,�/., �,