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Home My WebLink AboutM_Backflow Test Reports fire service_20211001_v1BACKFLOW PREVENTION ASSEMBLY TEST REPORTMama's Backflow (206) 353-4816 NAME OF PREMISE Willowcrest Townhomes ASSEMBLY ID/FILE #/UTILITY DEVICE #Meter # ACCOUNT # ZIP 98056SERVICE ADDRESS 1132 Edmonds Ave NE CONTACT PERSON Evan Chan PHONE (206) 900-8635 LOCATION OF ASSEMBLY In vault, in front of bldg B DOWNSTREAM PROCESS Fire Bypass MODEL 950XLD SERIAL NO.HC37380 SIZE 1" Commercial Residential APPROVED ASSEMBLY? NO PROPER INSTALLATION? YES NO NEW INSTALL EXISTING REPLACEMENT REMOVED OLD SER.# DCVA RPBA PVBA OTHER REMARKS: CALIBRATION DATE 07-27-2020 GAUGE #04162696 MODEL Midwest 845- CONFINED SPACE?No CERT. NO.B6604 DATE 4/12/2021 TESTERS NAME PRINTED Megan Bardsley TESTERS PHONE #(206)353-4816 PASSED FAILED PASSED FAILED LEAKED LEAKED LEAKED LEAKED PSID2.1 PSID1.9 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:Required minimum air gap separation provided?Detector Meter Reading LEFT SERVICE AS FOUND REPAIRED BY: FINAL TEST BY: DATE DATE TESTERS SIGNATURE: CERT. NO. LINE PRESSURE 105 PSI SERVICE RESTORED YES NO SOV#1:Open Closed SOV#2:Open Closed CHECK VALVE NO.2 Isolation valve:Open Closed YES LIC NO. WATER PURVEYOR Renton PUD RENTON CLOSED TIGHT CLOSED TIGHT RV EXERCISEDCLOSED TIGHT CLOSED TIGHT MAKE OF ASSEMBLY Wilkins YES NO BACKFLOW PREVENTION ASSEMBLY TEST REPORTMama's Backflow (206) 353-4816 NAME OF PREMISE Willowcrest Townhomes ASSEMBLY ID/FILE #/UTILITY DEVICE #Meter # ACCOUNT # ZIP 98056SERVICE ADDRESS 1132 Edmonds Ave NE CONTACT PERSON Evan Chan PHONE (206) 900-8635 LOCATION OF ASSEMBLY In vault, in front of bldg B DOWNSTREAM PROCESS Fire Service MODEL 350ASTDA SERIAL NO.19260 SIZE 4" Commercial Residential APPROVED ASSEMBLY? NO PROPER INSTALLATION? YES NO NEW INSTALL EXISTING REPLACEMENT REMOVED OLD SER.# DCVA RPBA PVBA OTHER DCDA REMARKS: CALIBRATION DATE 07-27-2020 GAUGE #04162696 MODEL Midwest 845- CONFINED SPACE?No CERT. NO.B6604 DATE 4/12/2021 TESTERS NAME PRINTED Megan Bardsley TESTERS PHONE #(206)353-4816 PASSED FAILED PASSED FAILED LEAKED LEAKED LEAKED LEAKED PSID2.9 PSID3.7 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:Required minimum air gap separation provided?Detector Meter Reading LEFT SERVICE AS FOUND REPAIRED BY: FINAL TEST BY: DATE DATE TESTERS SIGNATURE: CERT. NO. LINE PRESSURE 105 PSI SERVICE RESTORED YES NO SOV#1:Open Closed SOV#2:Open Closed CHECK VALVE NO.2 Isolation valve:Open Closed YES LIC NO. WATER PURVEYOR Renton PUD RENTON CLOSED TIGHT CLOSED TIGHT RV EXERCISEDCLOSED TIGHT CLOSED TIGHT MAKE OF ASSEMBLY Wilkins 000002.17YESNO