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Home My WebLink AboutCarmel Backflow ResponseFrom:Carmel Backflow To:Hannah Knight Subject:We have received your response for City of Carmel Backflow Test Form Date:Friday, May 22, 2020 1:07:26 PM Testers Email hannah.knight@koorsen.com Select Tester From List MOBLEY, JACOB_BF16-5584 Gauge Information N/A Phone Number (317) 542-1800 Calibration Date 12-04-2019 Select Company or Self Company Company Name Testing For Koorsen Fire & Security Phone Number (317) 542-1800 Address Street Address: 2719 N Arlington Ave City: Indianpolis State / Province: IN Postal / Zip Code: 46218 Select Service Use Commercial MANAGER NAME or COMMERCIAL CUSTOMER NAME M&J Wilkow Type a question N/A DEVICE LOCATION ADDRESS Street name: North Meridian Street House number: 10333 City: Indianapolis State: IN Postal code: 46290 Country: United States Existing, New or Replacing Device Existing Device Serial Number 3916445 Manufacturer of device Wilkins Device Size 1" Model Number Of Device 975XL2 Type of protection Containment Type Of Service Domestic Type a question Penthouse 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 10.0 Closed Tight YES Leaked NO Check Valve #2 Held At What PSID Closed Tight YES Leaked NO Pressure Differential Relief Valve Opened At What PSID 4.0 Did NOT Open Passed or Failed PASS Tagged YES Date 05/22/2020 10:30 AM 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 inchesabove overflow rim Supply size diameter Air Gap Date Time Testers Full Name:hannah.knight@koorsen.com Date 05/22/2020 1:00 PM Time