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Backflow Preventer Test 1-30-17
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Backflow Preventer Test 1-30-17
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Last modified
8/22/2023 5:39:47 PM
Creation date
2/8/2018 9:07:53 AM
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x Address Old
House Number
4005
Street Name
North Shore
Street Type
Drive
Address
4005 North Shore Dr
Document Type
Correspondence
PIN
0711723440003
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RECEIVEC <br /> American Society of Sanitary Engineering o bZU,J <br /> Reduced Pressure Principle Backflow Preventer (RP) <br /> ASSE Standard #1013 Field Test Report CITY OF ORON <br /> Owner of Property James&Vicki Splinter <br /> Address 4005 North Shore Dr <br /> City Orono State MN Zip Code 55364 <br /> Occupant of Property (if different from owner) <br /> Occupant Address <br /> City State Zip Code <br /> Manufacturer of Device: Zurn Wilkins Model#: 375XLRP <br /> Size of Device: 1" Serial#: B166914 <br /> Location of Assembly and Equipment or System Application: Pool Feed <br /> Test Equipment: <br /> Manufacturer: Wilkins Model#: TG-3 Serial#: 091010878 <br /> Calibration Date:02/18/2015 <br /> Date test was performed: 1/30/2018 Time test was performed: 3:00 PM Static Line Pressure: <br /> Check Valve#2 Shutoff valve#2 Check Valve#1 Pressure Differential <br /> Relief Valve <br /> Leaking (0) <br /> Initial Test Leaking CI) Leaking CI) Closed Tight (0) <br /> Closed Tight (0) Closed Tight (0) Pressure Drop Across Opened at psid <br /> Check Valve#1 _psid <br /> Describe parts <br /> and repairs <br /> when needed <br /> Leaking ([D <br /> Leaking CI) Leaking l) Closed Tight (0)Final Test Closed Tight (0) Closed Tight (13Pressure Drop Across Opened at 44psid <br /> Check Valve#1 52 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#: 95 3-8793 Pass II <br /> License#: P 0613r Certi -tion # 28072 Fail <br /> Signature Date: 1/30/2018 <br /> Comments or Recommendations (continue to other side,if needed): <br />
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