HomeMy WebLinkAbout05-04-2023 Backflow Test Report AQUAPO
Sprin lens
REC
Job #14513317 JUN 00 2023
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Backflow Test Report 0
Location & Customer Information
Complete Job Address Location Contact Name (Owner)
2670 Countryside Drive West, Long Lake, MN Robert Devere
55356 USA
Location Contact Phone Number
(612) 940-8149
Were you able to complete the Backflow
Test Today?
Yes
Device Information
Test Date Device Type
2023-05-04 PVB
Device Manufacturer Device Model
Febco Other
Device Model Device Serial Number
785 72A062
Device Size Device Location
1.0" Left
Test Results
Test: Pass OR Fail Shut-Off Valve #1
Passed Closes Tightly
Shut-Off Valve #2 Check Valve #1: Tightness
Closes Tightly Closes Tight
Check Valve #1: Spring Pressure Air-Inlet Valve OR Relief Valve Opened at
Differential PSI
PSI 5.00
2.00
Did you tag device?
Yes
Tester Information
Technician's License Number Test Completed By:
BT693475 Dillon
Tester
Signature
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