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Home My WebLink AboutBack Flow 10895 North Michigan Road Jamie Cunningham LD Huff Construction Project Management C: 317-496-4961 Jamie@ldhuff.com Begin forwarded message: From: Rob Dorsey <rob@justindorseyplumbing.com> Date: June 12, 2020 at 9:54:46 AM EDT To: Jamie Cunningham <jamie@ldhuff.com> Subject: FW: We have received your response for City of Carmel Backflow Test Form From: Michael Rodgers <Michael@justindorseyplumbing.com> Sent: Friday, June 12, 2020 9:47 AM To: Rob Dorsey <Rob@justindorseyplumbing.com> Subject: Fwd: We have received your response for City of Carmel Backflow Test Form Michael Rodgers - Service Manager 2378 State Road 236 Danville, IN 46122 317-525-4861 (c) 317-745-4830 (o) Begin forwarded message: From: Carmel Backflow <Backflow@carmel.in.gov> Subject: We have received your response for City of Carmel Backflow Test Form Date: June 11, 2020 at 11:09:01 AM EDT To: michael@justindorseyplumbing.com Reply-To: Backflow@carmel.in.gov Testers Email michael@justindorseyplumbing.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 Michael Rodgers Indiana State Certification Number bf19_06672 Gauge Information 10190876 Phone Number (317) 745-4830 Calibration Date 01-30-2020 Select Company or Self Self Select Service Use Commercial Type a question 1564886044 DEVICE LOCATION ADDRESS Street name: Weston Pointe Drive City: Zionsville State: IN Postal code: 46032 Country: United States Existing, New or Replacing Device New Device Serial Number 4784549 Manufacturer of device Wilkins Device Size 2 Model Number Of Device 975XL2 Type of protection Containment Type Of Service Domestic Type a question back of the building 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 9 Closed Tight X Leaked Check Valve #2 Held At What PSID Closed Tight X Leaked Pressure Differential Relief Valve Opened At What PSID 3.4 Did NOT Open Passed or Failed PASS Tagged YES Date 06/10/2020 3:00 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: Michael Rodgers Date 06/11/2020 10:40 AM Time Testers Email michael@justindorseyplumbing.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 Michael Rodgers Indiana State Certification Number bf19_06672 Gauge Information 10190876 Phone Number (317) 745-4830 Calibration Date 01-30-2020 Select Company or Self Self Select Service Use Commercial Type a question 1564886044 DEVICE LOCATION ADDRESS Street name: Weston Pointe Drive City: Zionsville State: IN Postal code: 46032 Country: United States Existing, New or Replacing Device New Device Serial Number 4784549 Manufacturer of device Wilkins Device Size 2 Model Number Of Device 975XL2 Type of protection Containment Type Of Service Domestic Type a question back of the building 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 9 Closed Tight X Leaked Check Valve #2 Held At What PSID Closed Tight X Leaked Pressure Differential Relief Valve Opened At What PSID 3.4 Did NOT Open Passed or Failed PASS Tagged YES Date 06/10/2020 3:00 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: Michael Rodgers Date 06/11/2020 10:40 AM 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 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 9 Closed Tight X Leaked Check Valve #2 Held At What PSID Closed Tight X Leaked Pressure Differential Relief Valve Opened At What PSID 3.4 Did NOT Open Passed or Failed PASS Tagged YES Testers Email michael@justindorseyplumbing.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 Michael Rodgers Indiana State Certification Number bf19_06672 Gauge Information 10190876 Phone Number (317) 745-4830 Calibration Date 01-30-2020 Select Company or Self Self Select Service Use Commercial Type a question 1564886044 DEVICE LOCATION ADDRESS Street name: Weston Pointe Drive City: Zionsville State: IN Postal code: 46032 Country: United States Existing, New or Replacing Device New Device Serial Number 4784549 Manufacturer of device Wilkins Device Size 2 Model Number Of Device 975XL2 Type of protection Containment Type Of Service Domestic Type a question back of the building 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 9 Closed Tight X Leaked Check Valve #2 Held At What PSID Closed Tight X Leaked Pressure Differential Relief Valve Opened At What PSID 3.4 Did NOT Open Passed or Failed PASS Tagged YES Date 06/10/2020 3:00 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: Michael Rodgers Date 06/11/2020 10:40 AM Time