HomeMy WebLinkAboutRenton PUD_09-06-23BACKFLOW PREVENTION ASSEMBLY TEST REPORTPOPS BACKFLOW TESTING INC.
(206) 551-5174
NAME OF PREMISE New Installs - 530, 534 & 538
ASSEMBLY ID/FILE #/UTILITY DEVICE #Meter #
ACCOUNT #
ZIP 98057SERVICE ADDRESS 530 Shattuck Ave S
CONTACT PERSON Trung (Daniel) Nguyen PHONE (206) 369-1061
LOCATION OF ASSEMBLY Front Closet by Front Door
DOWNSTREAM PROCESS Fire Service
MODEL LF007M2QT SERIAL NO.048357 SIZE 1.5"
Commercial Residential
APPROVED ASSEMBLY? NO PROPER INSTALLATION? YES NO
NEW INSTALL EXISTING REPLACEMENT REMOVED OLD SER.#
DCVA RPBA PVBA OTHER
REMARKS:
CALIBRATION DATE 12-14-2022 GAUGE #04133059 MODEL Midwest 835
CONFINED SPACE?No
CERT. NO.B6626 DATE 9/5/2023
TESTERS NAME PRINTED Solomon Salter TESTERS PHONE #(206)551-5174
PASSED
FAILED
PASSED
FAILED
LEAKED LEAKED
LEAKED LEAKED
PSID1.8 PSID1.7
PSID PSID
OPENED AT
#1 CHECK
AIR GAP OK?
OPENED AT
#1 CHECK
OPENED AT
HELD AT
LEAKED
CLEANED
REPAIRED
AIR INLET
CHK VALVE
INITIAL
TEST
DCVA / RPBA
CHECK VALVE NO.1
DCVA / RPBA RPBA PVBA / SVBA
PSID
PSID
PSID
PSID
PSID
PSID
PSID
PSID
NEW
PARTS
AND
REPAIRS
TEST AFTER
REPAIRS
DID NOT OPEN
CHECK VALVECLEAN REPLACE PART CLEAN REPLACE PART CLEAN REPLACE PART
AIR INLET
AIR GAP INSPECTION:
DETECTOR METER READING
LEFT SERVICE AS FOUND
REPAIRED BY:
FINAL TEST BY:
DATE
DATE
TESTERS SIGNATURE:
CERT. NO.
LINE PRESSURE 75 PSI
SERVICE RESTORED YES NO
SOV#1:Open Closed SOV#2:Open Closed
CHECK VALVE NO.2
Isolation valve:Open Closed
YES
LIC NO.Solomon Salter SALTESA832OQ
Solomon Salter B6626
WATER PURVEYOR Renton PUD
Renton
CLOSED TIGHT CLOSED TIGHT
RV EXERCISEDCLOSED TIGHT CLOSED TIGHT
MAKE OF ASSEMBLY Watts
PASS FAILSUPPLY PIPE DIAMETER SEPARATION
I certify that this report is accurate, and I have used WAC 246-290-490 approved test methods and test equipment.
BACKFLOW PREVENTION ASSEMBLY TEST REPORTPOPS BACKFLOW TESTING INC.
(206) 551-5174
NAME OF PREMISE New Installs - 530, 534 & 538
ASSEMBLY ID/FILE #/UTILITY DEVICE #Meter #
ACCOUNT #
ZIP 98057SERVICE ADDRESS 534 Shattuck Ave S
CONTACT PERSON Trung (Daniel) Nguyen PHONE (206) 369-1061
LOCATION OF ASSEMBLY Front Closet by Front Door
DOWNSTREAM PROCESS Fire Service
MODEL LF007M2QT SERIAL NO.048347 SIZE 1.5"
Commercial Residential
APPROVED ASSEMBLY? NO PROPER INSTALLATION? YES NO
NEW INSTALL EXISTING REPLACEMENT REMOVED OLD SER.#
DCVA RPBA PVBA OTHER
REMARKS:
CALIBRATION DATE 12-14-2022 GAUGE #04133059 MODEL Midwest 835
CONFINED SPACE?No
CERT. NO.B6626 DATE 9/5/2023
TESTERS NAME PRINTED Solomon Salter TESTERS PHONE #(206)551-5174
PASSED
FAILED
PASSED
FAILED
LEAKED LEAKED
LEAKED LEAKED
PSID1.5 PSID1.8
PSID PSID
OPENED AT
#1 CHECK
AIR GAP OK?
OPENED AT
#1 CHECK
OPENED AT
HELD AT
LEAKED
CLEANED
REPAIRED
AIR INLET
CHK VALVE
INITIAL
TEST
DCVA / RPBA
CHECK VALVE NO.1
DCVA / RPBA RPBA PVBA / SVBA
PSID
PSID
PSID
PSID
PSID
PSID
PSID
PSID
NEW
PARTS
AND
REPAIRS
TEST AFTER
REPAIRS
DID NOT OPEN
CHECK VALVECLEAN REPLACE PART CLEAN REPLACE PART CLEAN REPLACE PART
AIR INLET
AIR GAP INSPECTION:
DETECTOR METER READING
LEFT SERVICE AS FOUND
REPAIRED BY:
FINAL TEST BY:
DATE
DATE
TESTERS SIGNATURE:
CERT. NO.
LINE PRESSURE 75 PSI
SERVICE RESTORED YES NO
SOV#1:Open Closed SOV#2:Open Closed
CHECK VALVE NO.2
Isolation valve:Open Closed
YES
LIC NO.Solomon Salter SALTESA832OQ
Solomon Salter B6626
WATER PURVEYOR Renton PUD
Renton
CLOSED TIGHT CLOSED TIGHT
RV EXERCISEDCLOSED TIGHT CLOSED TIGHT
MAKE OF ASSEMBLY Watts
PASS FAILSUPPLY PIPE DIAMETER SEPARATION
I certify that this report is accurate, and I have used WAC 246-290-490 approved test methods and test equipment.
BACKFLOW PREVENTION ASSEMBLY TEST REPORTPOPS BACKFLOW TESTING INC.
(206) 551-5174
NAME OF PREMISE New Installs - 530, 534 & 538
ASSEMBLY ID/FILE #/UTILITY DEVICE #Meter #
ACCOUNT #
ZIP 98057SERVICE ADDRESS 538 Shattuck Ave S
CONTACT PERSON Trung (Daniel) Nguyen PHONE (206) 369-1061
LOCATION OF ASSEMBLY Front Closet by Front Door
DOWNSTREAM PROCESS Fire Service
MODEL LF007M2QT SERIAL NO.048158 SIZE 1.5"
Commercial Residential
APPROVED ASSEMBLY? NO PROPER INSTALLATION? YES NO
NEW INSTALL EXISTING REPLACEMENT REMOVED OLD SER.#
DCVA RPBA PVBA OTHER
REMARKS:
CALIBRATION DATE 12-14-2022 GAUGE #04133059 MODEL Midwest 835
CONFINED SPACE?No
CERT. NO.B6626 DATE 9/5/2023
TESTERS NAME PRINTED Solomon Salter TESTERS PHONE #(206)551-5174
PASSED
FAILED
PASSED
FAILED
LEAKED LEAKED
LEAKED LEAKED
PSID2.0 PSID2.5
PSID PSID
OPENED AT
#1 CHECK
AIR GAP OK?
OPENED AT
#1 CHECK
OPENED AT
HELD AT
LEAKED
CLEANED
REPAIRED
AIR INLET
CHK VALVE
INITIAL
TEST
DCVA / RPBA
CHECK VALVE NO.1
DCVA / RPBA RPBA PVBA / SVBA
PSID
PSID
PSID
PSID
PSID
PSID
PSID
PSID
NEW
PARTS
AND
REPAIRS
TEST AFTER
REPAIRS
DID NOT OPEN
CHECK VALVECLEAN REPLACE PART CLEAN REPLACE PART CLEAN REPLACE PART
AIR INLET
AIR GAP INSPECTION:
DETECTOR METER READING
LEFT SERVICE AS FOUND
REPAIRED BY:
FINAL TEST BY:
DATE
DATE
TESTERS SIGNATURE:
CERT. NO.
LINE PRESSURE 75 PSI
SERVICE RESTORED YES NO
SOV#1:Open Closed SOV#2:Open Closed
CHECK VALVE NO.2
Isolation valve:Open Closed
YES
LIC NO.Solomon Salter SALTESA832OQ
Solomon Salter B6626
WATER PURVEYOR Renton PUD
Renton
CLOSED TIGHT CLOSED TIGHT
RV EXERCISEDCLOSED TIGHT CLOSED TIGHT
MAKE OF ASSEMBLY Watts
PASS FAILSUPPLY PIPE DIAMETER SEPARATION
I certify that this report is accurate, and I have used WAC 246-290-490 approved test methods and test equipment.