3206 WAVE DR 2019-05-22 - Laserfiche WebLink

I) BATMASTER BACKFLOW PREVENTION ASSEMBLY TEST REPORT i i-,,,,,,,' (425)397-0275 WATER PURVEYOR Everett ACCOUNT# ASSEMBLY ID/FILE#/UTILITY DEVICE# Meter# NAME OF PREMISE Baldwin,Donna Commercial ❑ Residential ❑ SERVICE ADDRESS 3206 Wave Dr Everett ZIP 98203 CONTACT PERSON Donna Baldwin PHONE (425)353-7289 LOCATION OF ASSEMBLY IN BACK YARD,RIGHT UP NEXT TO HOUSE DOWNSTREAM PROCESS Irrigation System DCVA 0 RPBA ❑ PVBA ❑ OTHER NEW INSTALL 0 EXISTING ❑ REPLACEMENT ❑ REMOVED ❑ OLD SER.# APPROVED ASSEMBLY? YES d❑ NO❑ PROPER INSTALLATION?YES 0 NO ❑ MAKE OF ASSEMBLY Wilkins MODEL 9503______ SERIAL NO. 4274748 SIZE l INITIAL DCVA/RPBA DCVA/RPBA RPBA PVBA/SVBA CHECK VALVE NO.1 CHECK VALVE NO.2 AIR INLET TEST OPENED AT PSID CLOSED TIGHT I CLOSED TIGHT ❑- OPENED AT PSID PASSED ❑QLEAKED ❑ LEAKED ❑ #i CHECK PSID FAILED ❑ 2.9 PSID 3.0 PSID AIR GAP OK? DID NOT OPEN Ell CLEAN REPLACE PART CLEAN REPLACE PART CLEAN REPLACE PART CHECK VALVE NEW ❑ ❑ ❑ ❑ ❑ ❑ HELD AT PSID PARTS ❑ ❑ ❑ ❑ ❑ ❑ LEAKED ❑ AND ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ CLEANED ❑ REPAIRS REPAIRED ❑ TEST AFTER CLOSED TIGHT ❑ CLOSED TIGHT ❑ RV EXERCISED ❑ AIR INLET PSID REPAIRS LEAKED ❑ LEAKED ❑ OPENED AT PSID PASSED ❑ PSID PSID #1 CHECK PSID CHK VALVE PSID FAILED ❑ AIR GAP INSPECTION: SUPPLY PIPE DIAMETER SEPARATION PASS❑ FAIL❑ DETECTOR METER READING LEFT SERVICE AS FOUND Isolation valve: Open ❑.I Closed ❑ SOV#1: Open 0 Closed ❑ SOV#2: Open r❑ Closed ❑ REMARKS: LINE PRESSURE 112 PSI CONFINED SPACE? No TESTERS SIGNATURE: Cy 611144# CERT.NO. B6482 DATE 8/13/2018 TESTERS NAME PRINTED Cody Gobbato TESTERS PHONE# (425)397-0275 REPAIRED BY: LIC NO. DATE FINAL TEST BY: CERT. NO. DATE CALIBRATION DATE 02-15-2018 GAUGE# 02062045 MODEL 845-5 SERVICE RESTORED YES 0 NO ❑ I certify that this report is accurate,and I have used WAC 246-290-490 approved test methods and test equipment.