HomeMy WebLinkAboutbackflow preventer test CORVAL GROUP-
.01
/VBACKFLOW PREVENTER TEST REPORT
DATE: y`v // 2?/7
Site Name: 0/i ,4& Job# /5i"/
Site Address?7O 7/a/ l/i �1 /, ity: P'' Zip Code:
Contact: Phone#:
Owner: Phone#:
Owner Address: City: Zip Code:
/r
Make/Model of Device: x..,LA.ta 7 7O Size: T Serial#:h/C393
Serves What System: //-� /�r,�r Location: 80%/e ,ie_`7
Ck Valve Pres. Dif.Across Pres. Dif. when
Ck Valve#1 #2 #1 Ck relief opens Strainer
Leaked ( ) Leaked ) None
Test before Repair Close (�C Close (c /CSI '"/PSI Clnd ( )
Describe Repair .Z /a1�- i _$ ��- /11-C1741/4/1 Z/7L
Final Test Materials LeakedLeaked ,/ None
Used Close (S Close ( (PSI "'7PSI Clnd
CERTIFICATION:
I hereby certify the foregoing data to be correct and that the tested device is functioning within the limits of the
standards.
FIRM NAME: Corval Constructors, Inc. ADDRESS:� 1633 Eustis Street St. Paul MN 55108
BY:‘20e.,#-;,/ ae. CERTIFICATION#: �/6 9b PHONE: 651-645-0451
DATE: e�// REMARKS: .�-ds /.. .5/ 4 v2V
( ) INSTALL ( )TEST (*REBUILD ORIGINAL INSTALLATION DATE:
DATE OF LAST REBUILD: f //✓ 2o/9