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Home My WebLink AboutDomestic - Irrigation - (2) comm laundry Backflow Certs.pdf.. i^fl;J.It, '.,Ë'xtdítþ' i 'Åìff"t4qy BACKFLOW PREVENÎION ASSEMBLY TEST REPORTAffordable Washington Backfl ow Testing (360) 863-3784 WATER PURVEYOR RENTON ACCOUNT # ,PMBLY ID/FILE #ruTILITY DEVICE # Meter # NAME oF PREMISE Merrill Gardens Renton Commercial Ø Residential X SERVICE ADDRESS 104 Burnett Ave South Renton zf,p 98057 CONTACT PERSON Richard wright pHoNE Q06)396-0946 LOCATION OF ASSEMBLY In New Addition Water Room DOWNSTREAM PROCESS Domestic DCVA I npne M pVnl I Orngn_ NEWINSTALL U EXISTING t] REPLACEMENT f] REMOVED T OLD SER.# APPROVED ASSEMBLY? YES M IVO I PROPER INSTALLATION? YES U NO T] MAKE oF ASSEMBLY Watts uOnnr, LE909 sERIAL NO. W4 Stzn 4 - INITIAL TEST DCVA / RPBA CHECKVALVE NO.l DCVÂ / RPBA CHECK VALVE NO.2 DCrrl RPBA opÍ'r\r¡n rr i O PVBA/SVBA AIRINLET PASSED ¡ FAILED ø CLOSED TIGHT I LEAKED M PSID CLOSED TIGHT LEAKEI) PSII) #l cHEcK Orq_IDSJD AIR GAP OK? YCS DID NOT OPEN OPENED AT PSID CLEAN REPLACE PART CLEAN REPLACE PART T u T T T T T T CLEAN REPLACE PART cv1 CHECKVALVE HELD AT LEAKEI) T tr PSID T CLEANED RE,PAIRED TESTAFTER REPAIRS PASSED g FAILED n CLOSED TIGHT ø LEAKED T TIGHT P5ID CLOSED TIGHT ø LEAKED T TIGHT psil) RVEXERCISED T OPENEDAT 3.0 PSID #l cHEcK 6.8 PSID AIRINLET PSIDCHKVALVE PSID \IEW )PARTS AI\D REPAIRS AIR GAP INSPECTION: SUPPLY PIPE DIAMETER DETECTOR METER READING SEPARATION LEFTSERVICEASFOUNDIsolationvalve: Open I Closed l_] SOV*I: Open B Closed n SOV#2: Open pl Closed X REMARKS: LINE PRESSURE 69 PSI CONFINED SPACE? NO PASS E FAILT TESTERS NAME pRINTED David Foy TESTERS REpAIRED By: David Foy LIC NO. PHONE # (360)333-2057 FOY*DDT9O9BR DATE 07-10-20'19 t ,,* TEST BY:David Foy ¡ñI'ItT . ¡6. 85134 DATE 07-10-2019 CALIBRATION DATE 0t-22-2019 GAUGE # 03161194 MODEL Midwest 845 SERVICE RESTORED YES [¿ NO I I certify that this report is accurate, and I have used WAC 246-290490 approved test methods and test equipment ,. I-. ¡:.* i" w ãfþ'laif¿ Wasâtryhn ßûoffon, {fc a4t¡ 22t0, tt tÊ Wosdinvillr, WAtl072(il01¡¡¡.20¡t 6a¡l fr2.rfOtt: ACCOUNTf BACKFLOW FREVE].ITION ASgEÙIBLY TEST REPORT NAME oF pEEMtsE lr.nill Gardrns Ronton Corncrcld ! R¡ddcralrl tr sERvIcE aIlEREss 104 Burncü Avr South CTTY ,ri 9t057 coNTAcrPEEsoN ?HoNEeoq-c96-0946 FAx( ) LOCATION OFASSEMTLY On wdN in rir¡r røom DOWNSTTEÄ,M ?locf,ss lr.riEsiOn BCVA I ItXAtr ?VrA O (}lHEt NETYINSTALL EI DXTSTING I TS.'I,ICEMDNT E OT,PSEßT ?toppn IIìIsIALLATIoN? ygs E no tr urxsorrssnurry ,l{iftt0¡__ lmorr SlOXt'I2 sstr Lxo. 17_,l0t9l_ ¡¡zsj-1/?" I'CVA/EPNA ctEcr( vALvE tfo.r LEAI(ED EI ?.0 PSID ncvA/ntr^ CTECT VALVE NO.2 LEAKED O 2.1 PSID NPIA oPENED AT_PSID #r cHEcK_PSD AIß.GAPOI(? ryf,A/svDA AIRINLET OPENEDAT PSID DID NOT OPEN tr NEW PART$ AT{I) REP.{IRT¡ CLEA¡.I REPLACE PART tro tr EI tru0 tr CLEÂ¡T REPLÁCE PÁRT E tr tr tr tr EI tru CLEAI{ REPLACE PÂRT tr tr E¡ tr tro tr E C}IECKVAL1YTHELÞAT PSIDLEAKED tr CTEANED N,EPAIRED tr cl TEST A"F,TEI REPAIn!I PA.SSED tr FAILED tr LEAKED E PSID LEAKED E PSID OPENED AT PSID #I CHECK PSID A¡R TNLET *- PSID CHK VALVE PSID IMTIAL TEST PASSED I )FAILED N AIR GAP INSPECTION: Rcquiad uiniruumrirgap scporariorprovidcd? Yes El No tr REMARKS: Delector Metcr Readlng LIIYE PRESSURE 73 PST CONFINED SPACE?APTROVED DEVICE? YES E NO E TESTERS STGNATURE:CERT. NO. 86255 DATE 12-26-19 TESTERS NAME PRINTED: MATShAI MONEhAN TESTERS PHONET ( 360)333-2057 REPAIRED BY:DATE I.INA,L TEST BY: CERT. NO. _DA,TE CALIBRATION DATE OT22-IgGAUGE f 9:]1]:1MODEL845 MaKc MIdWESISERVICE RESTOR"ED? YES ET NO tr I cQdW that lhls report l$ dclutoter dnd I hdrQ t¡ed VÅC 2,16-290y'90 eppruwú tatt ûathods anú te$t equlpil ent. '!i áffm{aûû Ttlasûrryhn 'i* ',.. 'tv' a41¡ Zttth 3t tE Woodinvillr, WAll072 (tlo) $r.20¡t F¿¡l tt2.[0tllßûo$op, ífc BACKFLOW PREVENTION ASSEMBLY TEST REFORT ÄCCOUNT I NAMEOFPNEMISE Mrrrill Gerdon¡ Rr'nton Conncrchl I Rcddartl¡l El SEI.VICE aIIDRESS 104 Burneü At¡. Sot¡th CONTACÏ PEESON CITY Rrnton zE 9a057 PHoNE €0q-396-09¡16 FAx( ) ln Lrundrv fuom on wdl (lomrlLOCÁ,TTONÍ OF ASSDMTLY IX)}vtfsTlEAM ?toc'fss }[EIVTNSTALT, E BX¡STING E IETLACEÛruNT E OLÞ SEI" f DCVA G¡ E BAT PVI.ô, O OTHEr' ?f,O?ER, TIfSTALLATION? YES E TO tr t IMTIAL TEST ?ASSED 8 FAILED tr AIR CÁ,P INSPf,CTION: Rcquircdmilhrunrirgrpscpantionprcvidcdf Yes tr No tr REMARKS: Delector Metcr Rerding LINEPRESSUNE 76 PSI TESTERS SIGNATURET TESTERS NAME PRINTEI}: MATShAI MENEhAN REPAIRED BY: APPROVEDDEVICE? YES 8 NO E CONFINED SPACE? CERT. NO. 86255 DATE 12-26'19 TESTERSPHO¡|E#( 360)333-2057 DATE FINALTEST CERT. NO. _DATE CALIBRATION DATE o?22-lsGdUGE # 0s1611e4 MODEL$4S Make MidwesrSERvICE RESTORED? yES tr NO E I c.rl1/f' that rhl$ rcpùil l8 accurotet ¿ud I hoïe xceú ,fÅe 2¿6¿90490 cpptovd taîl methodt and teît qr¿tpüenl I}CVA/NPBAfficrvAl,vENo.l LEAKED E PSID DCVA/ EPtrA CIECXVALVE IìIO.2 LEAKED EI PSID nllA OPENED AT 3.0 PSID #r cHEcK_gåpsrp .ÀIR.GAPOK? X Fvna/l¡vlA AIRINLET oPENEÞAT_PSID DID NOT OPEN tr NE}V PARTS A¡iD REPAIRS CLEAI.I XEPLÁCE PÂRT tr tr tr ct tr tr trtr CLEAI.¡ REPLÁCE PÂRT tr tr tr ct tr tr tr E C'T,EâN R.EPLåCE PÁRT tr tr trtr tr tr trtr CI{ECKVALVEHELDAT PSIDLEAKED tr CLEANED REPAIREÞ tr tr TEST AFTEN, REPAIRII PASSED T] FAILED tr LEAKED B PSID LEAKED CI PSTD OPENED AT #r cHEcK PSID PSID AIR INLET PSID PSIDCHK VALVE .t i. ¡.1 .,'l: I" *t"' ãffúLûlc ltlatûW t4t¡ utaü' tt tE Woodinvillr, WAtû072 {r.01 ¡¡¡.2037 {44¡} r¡2¡r0r" fucffiü, lfc: ACCOUNTI NAME oF PREMI$E Mcrrill Gerdrn¡ Rrnton Conncrctrl I Rrlldclthl El SEAVICEAIþNESS 104 Êurn¡'tt A¡r South CTTY RTNTON ,ri 90057 CONTACT PEISON Loc¡,TroNoFAf¡sEMtr,y ln La¡ndy Room on wdl (ueoor) rxoxr €00-396-09¿16 FAx( ) DorvNsrnßAÈt ?toctss La¡ndy l'þt I\rE'w IN$TA¡,I E Exrsrr¡rc E r¡rr,tcgnÆNT El ot p sEt" I ncvl tr nr¡.rl !vrÄ. tr oTHEt ?lo?ßE TNsTALLATIoN? yE$ I wo tr IIYITIAL TEST PASSED E ,FAILEI} E .AIR GAP INSPDCTION: R.cquiæd mininrunr air gap scparation pruvidcdf Yes El REIVTARKS: No El Delector Metcr Rending tTSDoHAPPRovEDDEvIcE? YEs E No E'----;_7_---_:l.ll LINEPRISSURE 76 PSI CONFINED SPA,CE? I}CVA/ ruBÂcmcx vALvE No.r LEAKED EI PSID ncvA/nFlr CTDCT(VALVE NO.2 LEAKED g PSID NPIA OPENEDAT 3.2 PSID #l cHEcK_t.CI_PstD A¡R.GAPOT(? X PYBAISVBA AIRINLET oPENEDAT_PSID DID NOT OPEN tr NElry PART$ A¡{T) REPÄIRS CLEÂl.r REPLTiCE tÁRT tr tr trtr trtr E tr CLEAN REPLACE PÁRT tr tr tr tr tr E B tr CLEÂ}.¡ RAFLACE FART tr tru tr tr EI tr tr CTIECK VALVE I{ELDAT LEAKED CLEANED REPAIREÞ tru TEST AFTET REPAINS PASSED tr FAILED tr LEAKED g PSID LEAKED tr PSID OPENED AT #l clIEcK PSID PSTD AIRINLET PSID PSIDCHK VALVE rEsrERs srcNAruRE , '{ú,/"{/ã "¿1, u, Lt u TESTERS NAME PRINTED: MATShAI MENEhAN CERT. No' 86255 DATß 12-26-19 TESTERS PHO¡TE #( 360)333-2057 REPAIRED BY¡DATE FIN^AL TEST BY:CERT. NO. _D.{TE CAL¡BRATION DATE oÍ22-leGAtrGE t 0s1611s4 MODEL$4S Make M¡dwesrSERvICE RESTORßD? yES tr NO E I eart¡fi ûat thl$ rcpor¡ k a$unlqand I have r¡ed V'lC 21ó-290.d90 o?ptotçd tast methoùs onú test eqalpnent.