HomeMy WebLinkAboutBack Flow Test ResultsRhonda Bates
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From: bell@bellplumbingservice.com
Sent: Tuesday, June 11, 2019 11:10 AM
To: Rhonda Bates
Subject: FW: We have received your response for City of Carmel Backflow Test Form
Importance: High
Rhonda,
This is what I received from Carmel.
Let me know if you are needing something else.
Thanks,
Katie
From: Carmel Backflow <Backflow@carmel.in.gov>
Sent: Tuesday, June 11, 2019 8:47 AM
To: bell@bellplumbingservice.com
Subject: We have received your response for City of Carmel Backflow Test Form
Testers Email dbensheimer @gmail�cq_iLi
Testing Company's Email bcilC«)beliplumbiri rservice.com
Customers Email tclark capitalconstruct.com
Select Tester From List
BENSHEIMER, DAVID M. _BF00-1786
Indiana State Certification
Number
BF00 17860
—
Gauge Information
04133272
Phone Number
(317) 474 4990
Calibration Date
07-19-2018
Select Company or Self
Company
Company Name Testing
CAPITAL CONSTRUCTION SERVICES INC.
For
Phone Number
(317) 574-5488
Address
Street Address: 11051 VILLAGE SQUARE LANE
City: FISHERS
State / Province: IN
Postal / Zip Code: 46038
Select Service Use
Commercial
MANAGER NAME or
COMMERCIAL CUSTOMER
MCCALL HOLDINGS LLC
NAME
Type a question
49532222
DEVICE LOCATION
Street name: Horseferry Road
ADDRESS
House number: 12760
City: Carmel
State: IN
Postal code: 46032
Country: United States
Existing, New or Replacing
Existing
Device
Device Serial Number
189227
Manufacturer of device
Watts
Device Size
.75
Model Number Of Device
009-M3 QT
Type of protection
Containment
Type Of Service
Domestic
Type a question
MECHANICAL ROOM
Hazard Code
RP
Passed or Failed
PASS
DC
DC
Check Valve #1 Held At What PISD
2
Closed Tight
Leaked
Check Valve #2 Held At What PISD
Closed Tight
Leaked
Date
Time
DC DC
Check Valve #1 Held At What PISD
Closed Tight
Leaked
Check Valve #2 Held At What PISD
Closed Tight
Leaked
Date
Time
RP RP
Check Valve #1 Held At What PISD
Closed Tight
Leaked
Check Valve #2 Held At What PISD
Closed Tight
Leaked
Pressure Differential Relief Valve Opened At What PISD
Did NOT Open
Date
Time
RP RP
Check Valve #1 Held At What PSID 7
Closed Tight CLOSED TIGHT
Leaked
Check Valve #2 Held At What PSID 8
Closed Tight CLOSED TIGHT
Leaked
Pressure Differential Relief Valve Opened At What PSID 2
Did NOT Open
Passed or Failed PASS
Tagged YES
Date 06/10/2019 5:00 PM
Time
3
Notes
PVB
Date
Time
PVB
Date
Time
AIR GAP ONLY Final Test
Results
Date
Time
Testers Full Name
Date
Time
PASSED TEST AT 5 PM 06-10-2019 OK AT THIS TIME
PVB
Opened At What PSID
Did NOT Open
Did OPEN
Check Valve Held At What PSID
PVB
Opened At What PSID
Did NOT Open
Did OPEN
Check Valve Held At What PSID
Measured vertical inches Supply size diameter
above overflow rim
Air Gap
dbensheimer @grnal.coi
06/11/2019 5:00 AM
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