HomeMy WebLinkAboutfield test report-backflow preventer American Society of Sanitary Engineering
Reduced Pressure Principle Backflow Preventer (RP)
ASSE Standard #1013 Field Test Report
Owner of Property City of Orono
Address P.o.eox ss
Clty Crystal Bay Stat2 MN Zlp COd@ 55323
Occupant of Property (if differ nt from owner)
Occupant Address �• � (� GC/'�C�Q
City 0�'��B State /v Zip Code
Manufacturer of Device: Watts Model #: 919QT
Siz� of Device: 2" Serial#: 2683$
Location of Assembly and Equipment or System Application: Main water suppiy in water sortener room.
Test Equipment:
Manufacturer: W�ikins Model #: TG-3 Serial #: os�o�os�s
Calibration Date:o2i�si2o�5
Date test was performed: $/2/20�6 Time test was performed: 11:00 AM Static Line Pressure:
Check Valve#2 Shutoff valve#2 Check Valve#1 Pressure Differential
Relief Valve
Leaking (�
Leaking Q]) Leaking Q]) Closed Tight (�
Initial Test Closed Tight (� Closed Tight (� Pressure Drop Across Opened at_psid
Check Valve#1 sid
Describe parts
and repairs
when needed
Leaking (�
Leaking �]) Leaking �� Closed Tight (� 3
Final Test Closed Ti ht � Closed Ti ht � Pressure Drop Across Opened at_psid
g � g � Check Valve#1 8� sid
Celtlfled T2St@f (print)Dan Swanson Assembly Final Test
Addf2SS 1880-B West Wayzata Blvd Performance
Clty Long lake Statg MN Zjp 55356
Phone#:
952- 3-8793 Pass �
License : Pcsaa s Certifi ation # 28072 Fail ❑
Signature � Date: 8/2/2016
Comments or Recommendations (continue to other side, if needed):