HomeMy WebLinkAboutPenn Mark I - AI - BF - 9-12-19Ryan Fireprotection Inc.
9740 E. 148th St.
Noblesville, IN 46060
Phone: 800-409-7606
Account Information
Facility Name:
Penn Mark I
Property Type:
Not Specified
Location Code:
IZEBTJN
Service Address:
11595 North Meridian Street, Carmel, IN, 46032
Mailing Name:
Kevin Fredrick
Phone:
317-744-3088
Mailing Address:
11555 North Meridian Street, Carmel, IN, 46032
Assembly Information
Type:
RPZ
Assembly Description:
Backflow (Penthouse device)
Manufacturer:
WILKINS
Model:
975XL2
Serial Number:
4291801
Size:
3/4"
Type of Service:
Domestic
Type of Protection:
Containment Meter #:
Check Valve #1
Initial Test:
Pass Fail
Held at (PSID):
10.2 Closed Tight Leaked
Check Valve #2
Initial Test:
Pass Fail
Held at (PSID):
10.0 Closed Tight Leaked
Differential Pressure Relief Valve
Initial Test:
Pass Fail
Opened at (PSID):
2.7 Did not open
Tester Information
Comments:
The above is certified to be true at the time of testing Service Restored:
Yes No
Company Name:
Ryan Fireprotection Inc.
Company Address:
9740 E. 148th St., Noblesville, IN, 46060
Test Gauge:
Bill Rumbaugh - Midwest 845-5 (01061633, Last: 9/14/2018, Next: 9/14/2019)
Inspected By:
Bill Rumbaugh
Date of Test:
9/12/2019
Phone #:
800-409-7606
Tester Signature:Certification License:
BF97-1197
Form 2015-01 Backflow Page 1 of 1
Ryan Fireprotection Inc.
9740 E. 148th St.
Noblesville, IN 46060
Phone: 800-409-7606
Account Information
Facility Name:
Penn Mark I
Property Type:
Not Specified
Location Code:
IZEBTJN
Service Address:
11595 North Meridian Street, Carmel, IN, 46032
Mailing Name:
Kevin Fredrick
Phone:
317-744-3088
Mailing Address:
11555 North Meridian Street, Carmel, IN, 46032
Assembly Information
Type:
RPZ
Assembly Description:
Backflow (Domestic #3)
Manufacturer:
WILKINS
Model:
975XL
Serial Number:
3249669
Size:
2"
Type of Service:
Domestic
Type of Protection:
Containment Meter #:
Check Valve #1
Initial Test:
Pass Fail
Held at (PSID):
6.3 Closed Tight Leaked
Check Valve #2
Initial Test:
Pass Fail
Held at (PSID):
5.7 Closed Tight Leaked
Differential Pressure Relief Valve
Initial Test:
Pass Fail
Opened at (PSID):
2.6 Did not open
Tester Information
Comments:
The above is certified to be true at the time of testing Service Restored:
Yes No
Company Name:
Ryan Fireprotection Inc.
Company Address:
9740 E. 148th St., Noblesville, IN, 46060
Test Gauge:
Bill Rumbaugh - Midwest 845-5 (01061633, Last: 9/14/2018, Next: 9/14/2019)
Inspected By:
Bill Rumbaugh
Date of Test:
9/12/2019
Phone #:
800-409-7606
Tester Signature:Certification License:
BF97-1197
Form 2015-01 Backflow Page 1 of 1
Ryan Fireprotection Inc.
9740 E. 148th St.
Noblesville, IN 46060
Phone: 800-409-7606
Account Information
Facility Name:
Penn Mark I
Property Type:
Not Specified
Location Code:
IZEBTJN
Service Address:
11595 North Meridian Street, Carmel, IN, 46032
Mailing Name:
Kevin Fredrick
Phone:
317-744-3088
Mailing Address:
11555 North Meridian Street, Carmel, IN, 46032
Assembly Information
Type:
RPZ
Assembly Description:
Backflow (Domestic #2)
Manufacturer:
WILKINS
Model:
975XL
Serial Number:
3228778
Size:
2"
Type of Service:
Domestic
Type of Protection:
Containment Meter #:
Check Valve #1
Initial Test:
Pass Fail
Held at (PSID):
0 Closed Tight Leaked
Repairs and Materials Used
Final Test CV #1
Final Test:
Pass Fail
Held at (PSID):
0 Closed Tight Leaked
Check Valve #2
Initial Test:
Pass Fail
Held at (PSID):
0 Closed Tight Leaked
Repairs and Materials Used
Final Test CV #2
Final Test:
Pass Fail
Held at (PSID):
0 Closed Tight Leaked
Differential Pressure Relief Valve
Initial Test:
Pass Fail
Opened at (PSID):
2.4 Did not open
Tester Information
Comments:
The above is certified to be true at the time of testing Service Restored:
Yes No
Company Name:
Ryan Fireprotection Inc.
Company Address:
9740 E. 148th St., Noblesville, IN, 46060
Test Gauge:
Bill Rumbaugh - Midwest 845-5 (01061633, Last: 9/14/2018, Next: 9/14/2019)
Inspected By:
Bill Rumbaugh
Date of Test:
9/12/2019
Phone #:
800-409-7606
Tester Signature:Certification License:
BF97-1197
Form 2015-01 Backflow Page 1 of 1
Ryan Fireprotection Inc.
9740 E. 148th St.
Noblesville, IN 46060
Phone: 800-409-7606
Account Information
Facility Name:
Penn Mark I
Property Type:
Not Specified
Location Code:
IZEBTJN
Service Address:
11595 North Meridian Street, Carmel, IN, 46032
Mailing Name:
Kevin Fredrick
Phone:
317-744-3088
Mailing Address:
11555 North Meridian Street, Carmel, IN, 46032
Assembly Information
Type:
RPZ
Assembly Description:
Backflow (Domestic #1)
Manufacturer:
WILKINS
Model:
975XL
Serial Number:
3738908
Size:
1 1/2"
Type of Service:
Irrigation
Type of Protection:
Containment
Meter #:
68825156
Check Valve #1
Initial Test:
Pass Fail
Held at (PSID):
0 Closed Tight Leaked
Repairs and Materials Used
Final Test CV #1
Final Test:
Pass Fail
Held at (PSID):
0 Closed Tight Leaked
Check Valve #2
Initial Test:
Pass Fail
Held at (PSID):
0 Closed Tight Leaked
Repairs and Materials Used
Final Test CV #2
Final Test:
Pass Fail
Held at (PSID):
0 Closed Tight Leaked
Differential Pressure Relief Valve
Initial Test:
Pass Fail
Opened at (PSID):
3.3 Did not open
Tester Information
Comments:
The above is certified to be true at the time of testing Service Restored:
Yes No
Company Name:
Ryan Fireprotection Inc.
Company Address:
9740 E. 148th St., Noblesville, IN, 46060
Test Gauge:
Bill Rumbaugh - Midwest 845-5 (01061633, Last: 9/14/2018, Next: 9/14/2019)
Inspected By:
Bill Rumbaugh
Date of Test:
9/12/2019
Phone #:
800-409-7606
Tester Signature:Certification License:
BF97-1197
Form 2015-01 Backflow Page 1 of 1
Ryan Fireprotection Inc.
9740 E. 148th St.
Noblesville, IN 46060
Phone: 800-409-7606
Account Information
Facility Name:
Penn Mark I
Property Type:
Not Specified
Location Code:
IZEBTJN
Service Address:
11595 North Meridian Street, Carmel, IN, 46032
Mailing Name:
Kevin Fredrick
Phone:
317-744-3088
Mailing Address:
11555 North Meridian Street, Carmel, IN, 46032
Assembly Information
Type:
DCV
Assembly Description:
Backflow (Fire System Backflow)
Manufacturer:
WILKINS
Model:
350A
Serial Number:
U23072
Size:
6"
Type of Service:
Fire
Type of Protection:
Containment Meter #:
Check Valve #1
Initial Test:
Pass Fail
Held at (PSID):
0 Closed Tight Leaked
Repairs and Materials Used
Final Test CV #1
Final Test:
Pass Fail
Held at (PSID):
0 Closed Tight Leaked
Check Valve #2
Initial Test:
Pass Fail
Held at (PSID):
3.7 Closed Tight Leaked
Tester Information
Comments:
The above is certified to be true at the time of testing Service Restored:
Yes No
Company Name:
Ryan Fireprotection Inc.
Company Address:
9740 E. 148th St., Noblesville, IN, 46060
Test Gauge:
Bill Rumbaugh - Midwest 845-5 (01061633, Last: 9/14/2018, Next: 9/14/2019)
Inspected By:
Bill Rumbaugh
Date of Test:
9/12/2019
Phone #:
800-409-7606
Tester Signature:Certification License:
BF97-1197
Form 2015-01 Backflow Page 1 of 1