HomeMy WebLinkAbout2.8.24 - TEAM NELSON SOLERA BLDG A IRRIGATION DCVA COMMERCIAL NEW
RESIDENTIAL EXISTING
BACKFLOW RENTAL HYDRANT BACKFLOW
TEMP. BACKFLOW REPLACEMENT
CONFINED SPACE -
SIZE MANUFACTURER MODEL SERIAL
DCVA
#1 CHECK VALVE
#2 CHECK VALVE
WATER TIGHT
LEAKS
WATER TIGHT
__________PSID
LEAKS
WATER TIGHT
__________PSID
LEAKS
WATER TIGHT
__________PSID
LEAKS
RPBA
VENT VALVE
#2 CHECK VALVE
#1 CHECK VALVE
WATER TIGHT
LEAKS
WATER TIGHT
________PSID
LEAKS
OPENED@_______PSID
DID NOT OPEN
INITIAL TEST
PASS
FAIL
FAILED ON
ARRIVAL
UNABLE TO CONDUCT
TEST PROCEDURES
FINAL TEST
PASS
FAIL
INOPERABLE
ALL REPAIR
EFFORTS HAVE
BEEN EXHAUSTED
PVBA/SVBA
AIR INLET
CHECK VALVE
YES NO
AIR INLET FULLY OPEN?
OPENED@_____PSID
WATER TIGHT
__________PSID
LEAKS
PVBA/SVBA
AIR INLET
CHECK VALVE
WATER TIGHT
__________PSID
LEAKS
YES NO
AIR INLET FULLY OPEN?
OPENED@_____PSID
__________________________________B5889___________(425) 449-2072_________________________
TRAVIS GRANT — GRANT UTILITIES INC. CERTIFICATION TRAVISGRANT@ICLOUD.COM DATE
RPBA
DCVA
DCDA
BYPASS
RPDA
SVBA
PVBA
FIRELINE
DOMESTIC
IRRIGATION
HYDRANT
PROTECTION
TEMPORARY
SITEWATER
WATER TRUCK
TEMPORARY
SERVICE
NOTE:
DETECTOR S/N______________________________EXISTING METER S/N________________________ NEW METER S/N ___ _
LINE PRESSURE________PSI
DCVA
#1 CHECK VALVE
#2 CHECK VALVE
DEVICE VACUUM SEALED
CITY/WATER DIST. HYDRANT METER PEMIT#____________________
REPAIRS & FINAL TEST BY — TRAVIS GRANT — GRANT UTILITIES INC. ___________________________DATE___________________________________
CONTRACTOR JOB NAME
SITE ADDRESS CITY WATER PURVEYOR
DEVICE LOCATION
RPBA
VENT VALVE
#2 CHECK VALVE
#1 CHECK VALVE
WATER TIGHT
LEAKS
WATER TIGHT
________PSID
LEAKS
OPENED@_______PSID
DID NOT OPEN
HYDRANT PROTECTION
__________PSID
PRE-CERTIFICATION TEST REPORT
HYDRANT DEVICE Cl2 DISINFECTED
CITY/WATER DIST. HYDRANT METER S/N
APPROVED - LEAD FREE - SERVICE RESTORED PROPER INSTALLATION - YES NO YES NO YES NO YES NO YES NO BACKFLOW TESTING — RENTALS — SALES — REPAIRS — WATERMAIN DISINFECTION & DECHLORINATION — HYDRANT FLOW & MAIN CAPACITY TESTING GAUGE:MIDWEST 845-5 s/n 12220486 — CALIBRATION DATE: 24 JANUARY (FIELD GAUGE)GRANT UTILITIES INC.
SPECIAL WATERWORKS SERVICES
BOTHELL, WA
RENTONWATER DIST.
1" APOLLO DCLF4A 51269B
2.1
2.0
85
8 FEBRUARY 2024
TEAM NELSON SOLERA
2842 SUNSET BLVD NE RENTON
NW CORNER OF BLDG A