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1010 N BROADWAY STARBUCKS 2025-07-30
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1010 N BROADWAY STARBUCKS 2025-07-30
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Last modified
7/30/2025 4:16:23 PM
Creation date
4/23/2025 1:25:31 PM
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Address Document
Street Name
N BROADWAY
Street Number
1010
Tenant Name
STARBUCKS
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ACCOUNT# 87B— <br />INITIAL <br />CHEGn vn�` <br />TEST <br />Leaked ❑ <br />PASSED <br />® <br />CHECK VAQ <br />FAILED <br />Leaked ❑ <br />0. <br />CLEANING <br />REPAIRS <br />& PARTS <br />yr <br />ALWAYS TESTING INC. <br />6501 227th St. SW. MOUNTLAKE TERRACE. WA 98043 <br />(206) 718.8378 (425) 6724345 — <br />1 Relies ve <br />Opened 3. � psid/ Not Open❑ <br />O <br />psid <br />Check rf Leaked <br />2 Closed Tight L3a <br />psid Check Valve1_psid ❑ <br />Aenrnved Air Gap YES �ZNO <br />New Install <br />1 <br />�ENED A <br />PSID <br />D NOT OPEN <br />lend Fully Yes <br />El No <br />Check Valve <br />_psid <br />Leaked <br />FINAL TEST <br />CHECK VALVE NO. 1 <br />RELIEF VALVE <br />AIR INLET VALVE _psid <br />Leaked ❑ psid <br />Opened at <br />psid <br />Opened at psid <br />PASSED ❑ <br />CHECK VALVE NO. 2 <br />Check Valve 2 <br />Opened Fully Yes ❑40 ❑ <br />FAILED ❑ <br />Closed Tight <br />0 <br />Leaked❑ psid <br />Check Valve 1 <br />Check Valve psid <br />IF <br />psid <br />Air Gap Inspection: Pass❑Fail❑ <br />Supply Pipe Diameter <br />Air Gap Separation " <br />REMARKS: <br />Line Pressure PSI p <br />Detector Meter Reading <br />By this 1. 1 personally inspected and field-tested the backflow assembly using field test procedures meeting WAC <br />signature, 1 246-290.490 and test equipment meeting WAC 246-292-034; or 1 personally inspected the air gap or AVE. <br />certify: 2. The information in this re on is true, complete, and accurate. <br />TESTERSSIGNATURE G. CERT. NO. 3822 DATE 09/04124 <br />TESTERS NAME PRINTED Darin Schnee TESTERS PHONE # (206 ) 718 - 8378 <br />REPAIRED BY <br />- DATE <br />BAT Signature (after repair) CERT. NO. <br />DATE _ <br />CALIBRATION DATE 07111/2024 GAUGE # 0409 1223 MODEL 835 SERVICE RESTORED? YES ,®ENO <br />
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