20120125 Backflow Test 0530201205 /2e /EO1323:22 FA � ®Pnl
BACKFLO PRO'S, INC. - Backfk Prevention Assembl
855Troapar REEW sale lo0-AO 3w y
Tum eaarr, WA 56512 Test Report
Phone: 360851800 Fa:: 380.152 -1990
eelllrp Aebreaa
peylp:FEECO 850 LON DC
AHO -CHaD
ptDw:OSNI /13
lOHN6 MEADOW (IAT #dl)
'
1646] 5RR.R ST. SE
4,
YELM, 9
W WA A 9859>
Accountrum:5343
; q@
6..:TMA
Serial #: HC8097
Mater #:
Service Madness
Adtlmss: 16467 OREENEFI ST. SE
C#mpany:]OHNS FffiADOW (LOT#41)
Hwhird: RvFAtim- RmideOWl
Location: NEXT TO M8M
Reduced Pressure Princlpl
Assembly
a
pC
A6A�YH
Double Check VBlve Assembly
s°�,s
Check Va
Check Valve
a
�RNYFVaIVe
PVD/SYB
IxFada
MR Oil
Inillal
Test
Linked®
Closed TOME]
IDid no Open
DNIwt Open❑
HIM al_P61D
Held eL�PSID
M dsmi
Owed at PSID
CHECK VAI-W
eUR _PSID
Isaked ❑
Hew at PSID
Repale
Repaired®
ReOVlred(]
Closed TDM®
AIR WLET
Flood
Test
Hew at Z_ fi PSID
Haw at 26 MID
Op Rial MID
Opened al�PSiO
OHECKVA.
BuRar MID
Htltl a( PSID
DOmmaeb
LM Pressure 55
BOTHl K VALVE AI AND az LEAEP.D DUE! TO
SIVEPIPE
Haw Exodpressae®
DOPEIIPSYRFAM CLEANED AND FLUSHED ALSO
BOTH
CI'1C:CKVALVE #IANDRLMODULES. RETESTEDUOODI
#p Saulofl®
TFW abere
lapotlhwrffw m W Ime.
I
Relkl Vmve Eamkedt]
Oak Tenor 6DnahR9
Teabrr Team passed Failed
'added
Test
M2 W s MIpllkla
SWOR; "11"al ❑
Rpelre
/r
wouti2 W SMayealtl
051]0/12 W S ew/1161tl r
advii 0611961 ® ❑
3 cih+s vv..�do Loo!
MO 11 3P�' �1 � � aaar2sePee 9e 11 e