HomeMy WebLinkAboutCongressional Flex - Backflow Test Results
Testers Email gary.stewart@safecarecorp.com
Testing Company's Email info@safecarecorp.com
Customers Email danny@homeisjchart.com
Select Tester From List GIBSON, LUKE_BF18-6334
If Tester is not on the drop
down list please add their
information below
Gary Stewart
Gauge Information 06141620
Phone Number (317) 431-9503
Calibration Date 09-17-2019
Select Company or Self Company
Company Name Testing For Safe Care
Phone Number (317) 431-9503
Address Street Address: 749 S. Grant St.
City: Indianapolis
State / Province: Indiana
Postal / Zip Code: 46203
Country: United States
Select Service Use Residential
Residential Address: Street name: City Center Drive
House number: 805
City: Carmel
Postal code: 46032
Address Country: United States
Existing, New or Replacing
Device Existing
Device Serial Number 2035724
Manufacturer of device Wilkins
Device Size 2''
Model Number Of Device 975 XL
Type of protection Isolation
Type Of Service Domestic
Type a question Ware House
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 8.4
Closed Tight Closed Tight
Leaked
Check Valve #2 Held At What PSID Closed Tight
Closed Tight
Leaked
Pressure Differential Relief Valve Opened At What PSID 2.2
Did NOT Open
Passed or Failed PASS
Tagged YES
Date 11/13/2019 4:00 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: Luke Gibson
Date 06/15/2020 7:10 AM
Time