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American Society of Sanitary EngineerinRg <br /> Reduced Pressure Principle Backflow Preventer (RP) <br /> IVED <br /> ASSE Standard #1013 Field Test Report SEP 2 1 <br /> 2015 <br /> Owner of Property Orono Woods Apartments <br /> Address 2040 West Wayzata Blvd CITY OF ORONO <br /> City Orono State MN Zip Code 55356 <br /> Occupant of Property (if different from owner) <br /> Occupant Address <br /> City State Zip Code <br /> Manufacturer of Device: Watts Model #: oo9QT <br /> Size of Device: 1/2" Serial #: 179540 <br /> Location of Assembly and Equipment or System Application: Garbage Chute Cleaner <br /> Test Equipment: <br /> Manufacturer: Wilkins Model #: TG-3 Serial #: 091010878 <br /> Calibration Date: 02/18/2015 <br /> Date test was performed: 9/15/2015 Time test was performed: 12:00 Static Line Pressure: <br /> Check Valve#2 Shutoff valve#2 Check Valve#1 Pressure Differential <br /> Relief Valve <br /> Leaking (❑) <br /> Leaking CI) Leaking C) Closed Tight (❑) <br /> Initial Test Closed Tight (D) Closed Tight (ED Pressure Drop Across Opened at psid <br /> Check Valve#1 _psid <br /> Describe parts 5.2 psid <br /> and repairs <br /> when needed <br /> Leaking (EJ <br /> Leaking (0) Leaking CI) Closed Tight (ED <br /> Final Test Closed Tight (0) Closed Tight (0? Pressure Drop Across Opened at 4.1 psid <br /> Check Valve#1 8.1 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 /> 8793 Pass <br /> • <br /> Phone# <br /> License PC6441 : Certific:tion # 28072 Fail <br /> SignatureV_ /9A ; ,( ) Date: 9/15/2015 <br /> Comments or Recommendations (continue to other side,if needed): <br /> Rebuilt RPZ <br />