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Home My WebLink AboutMM II BFT 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 9:11:39 AM Testers Email Billy@performancefp.com Testing Company's Email joy@performancefp.com Customers Email DDawson@zellerrealty.com Select Tester From List SELECT IF TESTER IS NOT ON LIST If Tester is not on the drop down list please add their information below Billy Miller Indiana State Certification Number BF03_02301 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 Replacing Device Existing Device Serial Number u23052 Manufacturer of device Wilkins Device Size 6 Model Number Of Device 350A Type of protection Isolation Type Of Service Fire Type a question Pump Room Hazard Code DC 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 3.0 Closed Tight yes Leaked Check Valve #2 Held At What PISD 3.4 Closed Tight yes Leaked Date 08/02/2019 7:20 AM Time Device Pass or Fail PASS Device Tagged Yes 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 Closed Tight Leaked Check Valve #2 Held At What PSID Closed Tight Leaked Pressure Differential Relief Valve Opened At What PSID Did NOT Open Date 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:Billy Miller Date 08/08/2019 8:40 AM Time