HomeMy WebLinkAboutBackflow Test1
Mishler, Nicholas F
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
Right-click here tpictures. To helpprivacy, Outlookautomatic downlopicture from the
Testers Email dbensheimer@gmail.com
Testing Company's Email bell@bellplumbingservice.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
For CAPITAL CONSTRUCTION SERVICES INC.
2
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
NAME
MCCALL HOLDINGS LLC
Type a question 49532222
DEVICE LOCATION
ADDRESS
Street name: Horseferry Road
House number: 12760
City: Carmel
State: IN
Postal code: 46032
Country: United States
Existing, New or Replacing
Device Existing
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
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
3
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
Notes : PASSED TEST AT 5 PM 06‐10‐2019 OK AT THIS TIME
PVB PVB
Opened At What PSID
Did NOT Open
Did OPEN
Check Valve Held At What PSID
Date
Time
PVB PVB
4
Opened At What PSID
Did NOT Open
Did OPEN
Check Valve Held At What PSID
Date
Time
AIR GAP ONLY Final Test
Results Measured vertical inches
above overflow rim Supply size diameter
Air Gap
Date
Time
Testers Full Name: dbensheimer@gmail.com
Date 06/11/2019 5:00 AM
Time
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