HomeMy WebLinkAboutBack Flow Preventer Test Report 5.24.13 CORVAL GROUP
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BACKFLOW PREVENTER TEST REPORT
DATE: ' aZ � . /3
Site Name:GwV p + C i Yesz., Job # 1 5'83 O
Site Address: 13g f e 1 - CLIC- - 1 City: Pr/6 r k Zip Code: 55
Contact: P 1 1 Phone #: La D-Ct 9" —
Owner: `16(\c,A 9 11c,vi Phone #: Let �. " ,8 -CC-j
Owner Address: t3 gsO P4cLt2 /1VP. S City: U it U i t It Zip Code: 55 39"
Make /Model of Device: i,(/ce 4s e M Size: Serial #:
Serves What System: f60 / 41 1 Location: l4 cckutr^ cc& l go _d
Ck Valve Pres. Dif. Across Pres. Dif. when
Ck Valve #1 #2 #1 Ck relief opens Strainer
Leaked ( ) Leaked ( ) None ( )
Test before Repair Close ( ) Close ( ) PSI PSI Clnd ( )
Describe Repair
Final Test Materials Leaked ( ) Leaked () None (>
Used Close OO Close (-)() 5.0 PSI '- �SI Cind ( )
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: J:17.1c, CERTIFICATION #: ( PHONE: 651- 645 -0451
DATE: 1 13 REMARKS:
( ) INSTALL (» TEST () REBUILD ORIGINAL INSTALLATION DATE:
DATE OF LAST REBUILD: