HomeMy WebLinkAboutCity of Carmel Backflow Test Form (2)From:Carmel Backflow
To:info@bbgroupinc.com
Subject:We have received your response for City of Carmel Backflow Test Form
Date:Friday, May 21, 2021 10:24:52 AM
Testers Email info@bbgroupinc.com
Select Tester From List HAWLEY, JORDAN_BF19-6541
Gauge Information 01143232
Phone Number (317) 845-1701
Calibration Date 01-06-2021
Select Company or Self Company
Company Name TestingFor B&B Group
Phone Number (317) 845-1701
Address Street Address: 14470 Bergen City: Noblesville State / Province: INPostal / Zip Code: 46060
Select Service Use Commercial
Type a question 42949395
DEVICE LOCATIONADDRESS Street name: East Main StreetHouse number: 5790City: CarmelState: INPostal code: 46033Suite#:: United States
Existing, New orReplacing Device Existing
Device Serial Number 1732137
Manufacturer of device Wilkins
Device Size 1
Model Number Of Device 975
Type of protection Containment
Type Of Service Irrigation
Type a question Riser room
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
Closed Tight
Leaked
Check Valve #2 Held At What PSID
Closed Tight Yes
Leaked
Pressure Differential Relief Valve Opened At What PSID 3.6
Did NOT Open
Passed or Failed PASS
Tagged YES
Date 05/21/2021 9:00 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 FinalTest Results Measured vertical inchesabove overflow rim Supply size diameter
Air Gap
Date
Time
Testers Full Name:HAWLEY, JORDAN_BF19-6541
Date 05/21/2021 10:20 AM
Time