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EVEREY'T �D� <br /> Certified Backflow Testin9, Inc. <br /> (425)427-8889 •(20�601-5550•(888) 484FLOW•(425)427-9242 faa� .--�;� � ` � <br /> WWW.CBTINC.COM �DJ�\�I�Ci`�i� �, <br /> BACKFLOWPREVENTIONASSEMBLYTESTREPORT Ir�� A�iO � J 2��� "� � <br /> �000573 � `�/l��_ Pt1B� [�� 4t�URI{� i <br /> NANIE: AUTO ZONE y• Commercial � <br /> SERVICE ADDRESS: 11308 HWY 99 EVERETT. WA 98204 � <br /> i <br /> CONT.4CT PERSON: YELLOW IRON CONTRUCTION_ROBERT PHONE: 425322.8123 FAX: <br /> LOCATIOIV OF ASSEMBLY: NEAR W/M <br /> DOWM1STREAM PROCESS: iRRIGATION ASSEMBLY TYPE: DCVA <br /> INSTALLATION: NEW PROPER INSTALLATLON7 YES <br /> MAKE OF ASSEM118LY: WILKINS M1tODEL: 950XLU SERIAL#: 2617912 SIZE: 1.25 <br /> DCVA/RPBA DCVA/RPBA RPBA PVBA/SVBA <br /> INITIAL CHF.CK VALVE NO.1 CHECK VALVE N0.2 AIR INLET <br /> TEST: OPENED AT: PSID <br /> CLOSED T►GHT CLOSED TIGHT OPENED AT: PSID <br /> #1 CHECK: PSID OPENED FULLY? <br /> ASSE 3_O PSID 2_S PS[D p�R GAP OK? <br /> CHECK VALVE <br /> NEW HELD AT: PSID <br /> PARTC <br /> AND Please see nnres below Pfease see nntes below P/ease see nates belaw <br /> REP! <br /> TEST AFTER PSID PSID <br /> REPAIRS: OPENED AT: PSID AIRINLET: PSID <br /> CHK VALVE: PSID <br /> #1 CHECK: PSID <br /> AIR G.\P INSPECI'IOY: Reyuired minimum air gap� Detector MCtel'Reading: <br /> REn���Ks: <br /> TESTERS SIGNATURE: ��'^���� BAT#: B-4103 TEST DATE: 8/25/2011 LINE PSI: HH <br /> TESTCRS NAME PR[NTED: Loren R. Hanson COMPANY PHONE# please see lop ottest report <br /> REPAIRED BY: llATE: <br /> FINAL TEST BY: BAT#: DATE: <br /> CALIBRATION DATE: I/18/2011 KIT#: 1210U58 MODEL: MIDWF.ST 8d5-5 SERVICE RESTORED? YES \ <br /> !certiJi�tliut rhis repor�is uccum�r,nnd/hm�e usrd IV.iC]a6-:90-l90 upprared�est me�hods and�e.st equlpment I <br />