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Home My WebLink About317450 AMERICAN BACKFLOW & PLUMBING SERVICES, INC (877)-950-2468 Backflow Preventer Inspection & Field Test Report PWS ID Water System Name Renton, City of File # Facility Name Solera ☒Non-residential ☐ Residential Service Address 2955 NE 11th St City Renton Zipcode 98056 Contact Person Angelino Phone 2532582781 Email robertm@trademarkplumbingllc.com Hazard Type(if known) Trash Chute ☐DCVA ☐RPBA ☐PVBA ☐SVB ☐AG OTHER: RP ☒New ☐Existing ☐Replacement ☐Removed Confined Space Yes No Location: Bldg. A P2 in Trash Room Assembly Make Watts Model LF009M2QT Serial # 317450 Size 1 “ USC-Approved Yes☒ No☐Proper Install Yes☒ No☐ Proper Orientation Yes ☒No ☐ Initial Test Passed ☒ Failed ☐ DCVA RPBA PVBA / SVBA Check Valve 1 ☐Type II Relief Valve ☐Type II Air Inlet Valve Opened at psid Did Not Open ☐ Opened Fully Yes ☐ No ☐ Check Valve 0psid Failed ☐ Leaked ☐ psid Check Valve 2 Leaked ☐ psid Opened at 3 psid / Not Open ☐ Check Valve 2 Closed Tight ☒ Leaked ☐ Check Valve 1 8.7 psid Approved Air Gap Yes ☒ No ☐ Final Test Passed ☐ Failed☐ Check Valve 1 Leaked☐ psid Check Valve 2 Leaked ☐ psid Relief Valve Opened at psid Check Valve 2 Closed Tight Check Valve 1 psid Air Inlet Valve Opened at psid Opened Fully Yes ☐No ☐ Check Valve psid Air Gap Inspection Pass ☒ Fail ☐ Supply Pipe Meter “ Air Gap Separation “ Line Pressure 71 psi Detector Meter Gals CuFt Service Restored Yes ☒ No ☐ Remarks #1 Shut off found On ☒ Off ☐ #2 Shut off found On ☒ Off ☐ Upstream Shut off found On ☒ Off ☐ Test Kit Make & Model Mako MK5 Serial # 02AC21060168 Calibration Date 06/19/2024 By this signature, I certify: 1. I personally inspected and field-tested the backflow assembly using field test procedures meeting WAC 246- 290-490 and test equipment meeting WAC 246-292-034; or I personally inspected the airgap or AVB. 2. The information in this report is true, complete, and accurate. BAT Signature(initial test) Cert# B6758 Date /Time 10/07/2024 BAT Name (print) Kao Saechao BAT Phone # 877-950-2468 Repaired By Date/Time BAT Signature(after repair) Cert# B6758 Date/Time BAT Name(print) BAT Phone# 877-950-2468 BAT Company Name American Backflow & Plumbing Services, Inc. Address 5623 SE Center St, Portland, OR 97206 *Note unapproved backflow preventer, missing/defective components, repairs made, or conditions that may adversely affect assembly. Cleaning, Repairs & Parts Cleaned ☐ Repaired ☐ Comment: Disc O-Rings Diaphragm Check Spring Spring Module Float Seat Guide Rubber Kit Check Disc Air Inlet Spring Air Inlet Disc **The date of the most recent field test kit verification of accuracy or calibration whichever is most recent.