HomeMy WebLinkAboutPVB TEST REPORT 11/82016 ASSE International
Pressure Vacuum Breaker Assembly (PVB)
ASSE Standard #1020 Field Test Report
Owner of Property CalAtlantic(spec house)
Address 5337 Trailhead Lane
City Prior Lake j1p b , p'1°St eMN Zip Code
Occupant of Property (if different from owner) CatAtiantIS Hom
Occupant Address 7599 Anagram Drive
City Eden Prairie State MN Zip Code 55344
Manufacturer of Assembly: Apollo Model#: PVB4A
Size of Assembly: 1" °Serial#: A25023
Location of Assembly and Equipment or System Application: Front right corner of , irrigation
Test Equipment:
Manufacturer: Mid-West Backflow Model#: 845 Serial#: 02160302
Calibration Date:2-3-16 _
Date test was performed: 11-08-16 Time test was performed: 3:40pm Static Line Pressure: 80psi
Air Inlet Valve Check Valve Shut Off#2
Leaking CI
Failed to Open Closed Tight Leaking
Initial Test Opened at psid Pressure Drop Across Closed Tight 0
Check Valve#1 psid
Describe parts and
repairs when needed
Leaking E
2.2 Closed Tight Leaking D
Opened at psid g Q
Final Test Pressure Drop Across Closed Tight fj
Check Valve#1 1.4 psid
Certified Tester(print)Scott Ludwig Assembly Final Test
Address 2200 West Highway 13 Performance
City Burnsville State MN zip 55337 Pass •
Phone#: 952-767-1000
License#: BF064036 Certification# ASSE#30730 Fail
Signature VIA Date: 11-08-16
Comments or Recommendations (continue to other side,if needed):