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HomeMy WebLinkAboutMM II BFT 4 8-2-19From:Carmel Backflow
To:Billy@performancefp.com
Subject:We have received your response for City of Carmel Backflow Test Form
Date:Thursday, August 8, 2019 12:42:53 PM
Testers Email Billy@performancefp.com
Testing Company's Email joy@performancefp.com
Select Tester From List BECHERT, SHAWN _BF14-5001
If Tester is not on the
drop down list please add
their information below
Billy Miller
Gauge Information 02030722
Phone Number (317) 5385389
Calibration Date 10-30-2018
Select Company or Self Company
Company Name Testing
For Performance Fire Protection
Phone Number (317) 538-5389
Address Street Address: 5602 Elmwood Ave Ste 117
City: Indianapolis
State / Province: IN
Postal / Zip Code: 46203-6071
Select Service Use Commercial
MANAGER NAME or
COMMERCIAL
CUSTOMER NAME
Zeller Realty
Type a question 67203636
DEVICE LOCATION
ADDRESS
Street name: North Meridian Street
House number: 11711
City: Carmel
State: IN
Country: United States
Existing, New or Existing
Replacing Device
Device Serial Number 3228779
Manufacturer of device Wilkins
Device Size 2
Model Number Of Device 975xl
Type of protection Isolation
Type Of Service Domestic
Type a question Pump 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
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 7.8
Closed Tight Yes
Leaked
Check Valve #2 Held At What PSID 8.0
Closed Tight Yes
Leaked
Pressure Differential Relief Valve Opened At What PSID 2.1
Did NOT Open
Passed or Failed PASS
Tagged YES
Date 08/02/2019 8:40 PM
Time
PVB PVB
Opened At What PSID
Did NOT Open
Did OPEN
Check Valve Held At What PSID
Date
Time
PVB PVB
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:Shawn Bechert
Date 08/08/2019 12:30 PM
Time