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05-04-2023 Backflow Test Report
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05-04-2023 Backflow Test Report
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Last modified
8/22/2023 5:07:04 PM
Creation date
6/8/2023 2:13:30 PM
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x Address Old
House Number
2670
Street Name
Countryside
Street Type
Drive
Street Direction
West
Address
2670 Countryside Dr W
Document Type
Misc
PIN
0411723120013
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AQUAPO <br /> Sprin lens <br /> REC <br /> Job #14513317 JUN 00 2023 <br /> !Tv f'-‘7- <br /> Backflow Test Report 0 <br /> Location & Customer Information <br /> Complete Job Address Location Contact Name (Owner) <br /> 2670 Countryside Drive West, Long Lake, MN Robert Devere <br /> 55356 USA <br /> Location Contact Phone Number <br /> (612) 940-8149 <br /> Were you able to complete the Backflow <br /> Test Today? <br /> Yes <br /> Device Information <br /> Test Date Device Type <br /> 2023-05-04 PVB <br /> Device Manufacturer Device Model <br /> Febco Other <br /> Device Model Device Serial Number <br /> 785 72A062 <br /> Device Size Device Location <br /> 1.0" Left <br /> Test Results <br /> Test: Pass OR Fail Shut-Off Valve #1 <br /> Passed Closes Tightly <br /> Shut-Off Valve #2 Check Valve #1: Tightness <br /> Closes Tightly Closes Tight <br /> Check Valve #1: Spring Pressure Air-Inlet Valve OR Relief Valve Opened at <br /> Differential PSI <br /> PSI 5.00 <br /> 2.00 <br /> Did you tag device? <br /> Yes <br /> Tester Information <br /> Technician's License Number Test Completed By: <br /> BT693475 Dillon <br />
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