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HomeMy WebLinkAbout19020095 Backflow Test ResultsCity Of Carmel Backflow Test Form 1 -Submission ID 4136067892619812898 Submission Date, 2018-09-24 09:59:49 Thiis,Form-i& - being; Updated.d6ily wfth.more,options, ',All upilated;mformition cdn'beJouhd:at htt s://S'ites:000cile:corri/View7c'a�rmelbackf low Contact Us Form When enterinqan,emaii,-r&;f(rst one-'-is,req'uirdd:�A-.notice -will 'be',sbnt to`idve-ry:email entered., Test6s1mall Test ling:Cqrnpanys Email_ customers Email' tony.hughes@grunau:us brian.sauer@grunau.us erin.shepherd@cushwake.com TESTERINFORMATIONI-. S(!16ct:T'e-steriFf6th;List-.1f.. HUGHESJONY BF11-4199 idsterls not on list, 'Select The First,,!'Field Noton List" and then, enter their' information below, Gauge Information 4152475 Phone Number (317) 872-7360 Calibration Date` 04-09-2018 Select Company or. Self Company I COMPANY. INFORMATION'S I . ,Company -Name Testing For Grunau PtibniMumber (317) 872-7360 ri Address 6011 East Hanna Suite A Indianapolis IN 46203 .SERVICE TYPE selecttService;Us6' Commercial Resideihfia[ Information Mang''gpr or.o--'C"--mth--er-c'ia-l:'Ih-fbrtnatibn ., DEVICE LOCATION Street name: Hamilton Crossing Boulevard ADDRESS House number: 121302 City: Carmel State: IN Postal `code: 46032 Country: United States HOAAnfo"rmatibn Dev'i'C6- Ihsi:#Iff hforMAtidh-, Existing, New or'Re , pia.cing- Existing Device - Device Info'rm'aitibn Ddvicei Serial Number: 21056 Manufa cturer,df cleviceL Wilkins DeVice;Slze 6.0 Model Number Of Device 375A Type of protection Containment -type,of service Domestic Device Hazard Code-, Hazard Code RP 'DeVice InitiM Test Pass, or Fall, Option Selecting Pass will open, the Final Test Page and Fail will open Initial Test Page Passed or Failed, Yes DC!D- lniti'al;Tbst,Results, DC.- Final Test R680ts RP "RIP',-Imitial Test -Results RR'- Final Test Results Check Valve]#1 Held AfWhat PSID, 66sied Tight Leaked Check Valve,#2 Held,At What PSID' Closed Tight � Did NOT Open RP 8.0 y — N 2.8 Y At What PSID 1 5.2 Passed'or Failed Yes Tagged YES Date- 09/14/2018 11:30 AM PUB lInitialTe.st Ae§Ults, PVB - Final Test Results AIR = Final Test; Results . Sign and: Acknowledgement° By signing this backflow'test report, I hereby certify that l am familiar with the information contained in this form and that to the best of my knowledge and belief, such information is true, complete and accurate at the time of the test. Testers.Full Narne: Tony Hughes Date 09/24/2018 9:50 AM You Ha"v"e to Preview tfie forms8ef6re;.you.can submit: