Laserfiche WebLink
EVERETT �D� <br /> � Certified BacNflow Testing, Inc. _ <br /> (425)427-8889 •(206)601-5550•(888)484FLOW •(425) 427-9242 \ �U <br /> WWW.CBTINC.COM �J�--�;�i'I� i ',-'��-�- � <br /> ��, D, <br /> ' AL'S 29 2i,i1 <br /> BACKFLOYf�PREVENTIDNASSEMBLY TEST REPORT <br /> �ObO 575✓ �'tJB! I�� 11 U�:KS <br /> NnME: AliTO ZONE •• Commercial �,p�T- <br /> SERVICE ADDRESS: 11308 HWY 99 EVERETT. WA 98204 <br /> CONTACT PERSON: YELLOW IRON CONTRUCTION ROBERT PHONE: 425322.8123 FAX: <br /> LOCATION OF ASSEMBLY: VAULT IN PARKING LOT <br /> DOWNS'fREAn1 PROCESS: FIRELINE ASSEMBLY TYPE: DCDA <br /> INSTALLATION: NEW PROPER I:YSTALLAT[ON?YES <br /> MAKE OF ASSEMQLY: WILKINS �tonE�: 350ADA SERIAL#: V27322 SIZE: 6 <br /> DCVA/RPBA DCVA/RPBA RPBA PVBA/SVBA <br /> INITIAL CHECK VALVE NO.1 CHECK VALVC N0.2 A[R INLET <br /> TEST: OPENED AT: PSID <br /> CLOSED TIGHT CLOSED TIGHT OPE:JED AT: PSID <br /> #1 CHECK: PSID OPENED FULLY? <br /> ASSE 4_i PSID 4y3 PSID p�R GAP OK? <br /> CHECK VALVE <br /> NEW HELD A1': PSID <br /> PARTS <br /> AND Plense sec nnles be/r�w P/ease see rroles helnw Plense see notes belnw <br /> REPAIRS <br /> TEST AFTER PSID PSID <br /> REPAIRS: OPENED AT: PSID AIR INLET: PSID <br /> CHK VALVE: PSID <br /> nl CHECK: PSID <br /> AIR CAP INSPECTION: Rcquirtd minimunt air;a�? Detectar Meter Reading: <br /> REMARKS: <br /> TESTERS SICNATURE: cC��'"-� UAT#: B-4103 TEST DATE: 8/25/2011 LINE PSL• Sg <br /> TESTERS NAME PRINTED: Loren R. Hanson C061PANY PHONE# please see top o�test report <br /> REPAIRED BY: DATE: <br /> FINAL TEST BY: DAT#: DATE: <br /> CALIBRATION DATG: 1/18/2011 KIT tt: 12101758 MODEL: MIDWEST 8J5-5 SERVICE RESTORED? YES <br /> ` / <br /> /certijy Umt�his rqiort is aceura�e,and!hurr used IYAC 2f6-190-�90 apprm�ed test mr�hads and�rst equlpmmt. �I <br />