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Home My WebLink About3/21/02 bfp500marketAAA MECHANICAL CONTRACTOR P.02×04 MAR-O?-2002 10:48 ~ACKFLOW PREVENTION ASSEMBLY TEST DATA AND MAINTENANCE REPORT TYPE OF A~$EMgLY · ~EIGHT OF; TrME 6:30 MANUFACTUI~R PROTG~TION FROM: INITIAL TEST Passed Faired REDUCED PRESSURE pRINCIPAL ASSEMBLY: n m 13193510?4? SUPPLY ~:~/,t..~ IN. GAP '~ IN. I~ FA,L T ST CHECK held in direction of flow <~j~, ~. PSID .(S PSID or more) [] 1:3 RELIEF VALVE opened at C4.~. PSID (2 PSID or more) [] 13 DIFFERENCE (1st ~heck - relief) C4';_~_ PSID (3 PSID or more) [] [] 2ND CHECK held backpressure [] [] NO. 2 SHUTOFF VALVE leak tight [] [] 2ND CHECK held in d;rectlon of flow ~..__~ PSID (1 PSID or more) [] [] RELIEF VALVE exercised to full open position [] [] NOTE: Failure of any of the above items, requires repair. COMMENTS: I NEW' ~ISTALL~TION I ~ YES [] NO INITIAL TEST Passed Failed DOUBLE CHECK VALVE ASSEMBLY: [] 1 ST CHECK held in direction of flow PSID (1 PSID or more) [3 [] 2ND CHECK held hat'pressure NO. 2 SHUTOFF VALVE leak tight 2ND CHECK held. in direction of tlow. PSID (1 PSID or more) ¢3 [] NOTE: Failure of any of the above itenl$, requires repa'.'r. FINAL TEST AFTER REPAIR Passed Failed REDUCED PRESSURE PRINCIPAL ASSEMBLY: [] O INITIAL TEST PRESSURE VACUUM BREAKER; Passed internal check held tight in direction of flow PSID {1 PSID or more) [] Inlet Poppet opened at~ PSID (1 PS[D or more) [] NOTE: Failure of any of the above items, requires repair. INITIAL TEST APPROVED APPLICA'/'IONS ONLY Failed [] APPROVED APPECA T/ON$ OIVL Y 1ST CHECK held in direction of flow PSID {5 PSID or more) RELIEF VALVE opened at ~ PSID (2 PSID or more) DIFFERENCE (1st check - relief) PSID {3 PSID or more) 2ND CHECK held bac~pressure NO. 2 SHUTOFF VALVE le~k tight 2ND CHECK held in direction of flow · PSID (1 PSID or more) RELIEF VALVE exercised to full open position FINAL TEST Al- IER REPAIR Passed Failed DOUBLE CHECK VALVE ASSEMBLY: [] [] 1ST CHECK held in direction of flow PSID (1 PSID or more) O D 2ND CHECK held backpressure I~ 0 NO. 2 SHUTOFF VALVE leak right ~ [] 2ND CHECK held in direction of flow PSID {1 PSID or more) L3 [] ANTI-SPILL VACUUM BREAKER; Passed Failed Oii~ferential pressure across check was PSID (1 PSID or more) [] D Air inlet star: tO open at . PSID l1 PSlD or more) [] O Air inlet [ully open when supply pressure atmospheric [] [] NOTE: Failure of any of the above items, requires repai~. FINAL TEST AFTER REPAIR PRESSURE VACUUM BREAKER: Passed Failed internal check held tight in direction of flow PSID {1 PSID or more) ~'.1 [] Inlet Poppet opened at~ PSID {1 PSID or morel [] O FINAL TEST AFTER REPAIR ANTI,SPILL VACUUM BREAKER: Passed Failed Differentinl pressure across check was PSID (1 PS1D or more) [] [] Air inle~ start to open at PSID (1 PSID of morel 1:3 El Air inlet fully open when supply pressure atmospheric O O COMMENTS REPAIR HISTORY ,' THE ASOVE .E.ORT IS RTIPIE TO ^CCU T'E ^.O COMPUETE. ~ompanv & Ad,ross: AAA Mechanical Contractors,_ . Inc._. P.O. ~x ~05, _Iowa. City 0296 Pho.. MAR-O?-2002 10:48 AAA MECHAN I CAL CONTRACTOR IACKFLOW PREVENTION ASSEMBLY TEST DATA AND MAINTENANCE REPORT ... I 13193510?4? METER NUMeER P.03/04 TIM; "~'A,M, HEr~HT It:]FI= ItLOOPl ~ I~0T~:TION FROM,' INITIAL TEST Passed Failed REDUCED PRESSURE PRINCIPAL ASSEMBLY: m [] 1ST CHECK held in ,,_~ direction of flow ~ ,PSIO '(5 PSID or more) r't [] RELIEF VALVE opened et ~,1~ PSID (2 PSID or more) D 13 DIFFERENCE Ilst check - reliefi ~ PSID (3 PS;D or more) [] [] 2ND CHECK held backpressure [] [] NO. 2 SHUTOFF VALVE leek tight [] [] 2ND CHECK held in direction of flow ]~c~ PSlD (1 PSID or morel El RELIEF VALVE exercised to full open position [] El FINAL TEST AFTER REPAIR Passed Failed REDUCED PRESSURE PRINCIPAL ASSEMBLY: [] [] 1ST CHECK held in direction of flow PSID (5 PSID or more) CI [] RELIEF VALVE opened at PSID (2 PSID or more) [] [] DIFFERENCE (1st check - relief) ~ PSID {3 PSID or more) [] J [] 2ND CHECK held backpressure ~ [] NO. 2 SHUTOFF VALVE leek tight [] [] 2ND CHECK held in direction of flow PSID (1 PSID or more) [] [] RELIEF VALVE exercised to fuji open position [] [] NOTE: Failure of a~ly of the above items, requires repair. INITIAL TEST Passed Failed DOUBLE CHECK VALVE ASSEMBLY: ~ E] 1ST CHECK held in direction of flow PSID (1 PSID or more) [] [] 2ND CHECK held backpressure [] [] NO. 2 SHUTOFF VALVE leak tight [] [] 2ND CHECK held in directk)n of flow PSID [1 PSID or more) 0 [] NOTE: Failure of any of' ti3; above items, requires repair. FINAL TEST AFTER REPAIR Passed Failed DOUBLE CHECK VALVE ASSEMBLY: 1ST CHECK held in direction of flow PSID (1 PSID or more) [] [] 2ND CHECK held bac~cpressure [] [] NO. :2 SHUTOFF VALVE leak tight [] [] 2ND CHECK held in direction of flow PSID (~ P$ID or more) i~ [] INITIAL TEST PRESSURE VACUUM BREAKER: Passed Internal check held tight in direction of flow PSID (1 PSID or more} 13 In(et Poppet o~ened at~ PSID (1 PSIO or mote) 0 NOTE: Failure of any of the above items, requires repair. INITIAL TEST ~ PPRO VEO A ~PI. IC.4 7'iONS ONLY Failed [] APPROVED AP?L/CA T/ON$ ONLY FINAL TEST AFTER REPAIR PRESSURE VACUUM BREAKER: Passed Failed Interna~ check held tight in direction of flow PSIO (1 PSID or more) [] [] Inlet Poppet opened al: ~ PSID (1 PSiD or more) [] r-i FINAL TEST AFTER REPAIR ANTI-SPILL VACUUM BREAKER: Passed Failed Differential pressure across check was 'PSID [1 PSID or more] [] [] Air inlet start to open at PSID {1 PSID or more) ED [] ),ir in[at fully open when supply pressure atmospheric 1~ [] NOTE; Fa[lute of any of the above items, requites reps}to ANTI-SPILL VACUUM BREAKER: Passed Failed Differentia] pre, sure across check was PSID (1 PSID or morel In O Air inlet start [o open at ..-- PSID {1 PSIO or morel [] 13 Air inlet fully open when supply pressure atmospheric [] [] COMMENTS REPAIR M~STORY THE ~,~OVE REPORT I$ cERTIFIED TO BE TRUE, A~TE AND COMPLETE. 7~sTed ~V: [Pcmnt] Comoany & Address: AAA Mechanical ' Cu~TO~f of Contractors, Ing. P.O. Box 805, .~owa Cit~ J 319/351-1843 ARA MECHRNICAL CONTRRCTOR MAR-O?-2002 10:49 BACKFLOW PREVENTION ASSEMBLY TEST DATA AND MAINTENANCE REPORT 13193S10747 P.04×04 IN, INBV [NS'rAJJ.k?IQN INITIAL TEST Pas~ed Failed REDUCED PRESSURE PRINCIPAL ASSEMBLY: 1:3 El I ST CHECK held in direction of flow [] [3 RELIEF VALVE opened at 13 [] DIFFERENCE. (1 st check - relief) /"{'-.__~ PSID {3 PSIO o¢ more) 13 13 2ND CHECK held backpressure [] [] NO, 2 SHUTOFF VALVE leak tight [3 [3 2ND CHECK held in direction of flow '?..,~ PSID (1 PSID or more) 13 13 RELIEF VALVE exercised to full open position [] 1:3 ~,1~ PSID (5 PSID or more) ~ PSID (2 PSID or more) FINAL TEST AFTER REPAIR Passed Failed REDUCED PRESSURE PRINCIPAL ASSEMBLY: [] 13 1 ST CHECK held in direction of flow ~ PSID {5 PSID or more) [] [] RELIEF VALVE opened at ~. PSIO (2 PSID or more) [] 13 DIFFERENCE (1st check, relief) __ PSID (3 PSID or more) 2ND CHECK held backpressure 13 13 NO. 2 SHUTOFF VALVE leak tight 13 [] 2NO CHECK held in direction of flow ~-- pSID (1 PSIO or more) 13 RELIEF VALVE exercised to full open position 13 [] NOTE: Failure of any of the above items, requires repair. INITIAL TEST Passed Failed DOUBLE CHECK VALVE ASSEMBLY: [] O 1 ST CHECK held in direction of flow PSID I1 PSID or more) [3 [] 2ND CHECK held bac~l~ressure [] [] NO, 2 SHUTOFF VALVE leak tight [] O 2ND CHECK held in direction of lIow PSID (1 PSID or morel r3 [] FINAL TEST AFTER REPAIR NOTE: Failure of any ~-f-the above kerns, requires repa?r. INITIAL TEST PRESSURE VACUUM BREAKER: Passed Internal check held rich! in direction of flow PS1D (1 PSID or morel O In~et P~ppet ol3ened et__ PSID (1 PSID or more) [] NOTE: Failure of any of the above items, requires repair. .4PPROVEO APPI. IC4 T/ONE ONLY Failed [] INITIAL TEST APPROVED APPf./CA TION$ ONLY DOUBLE CHECK VALVE ASSEMBLY: 1ST CHECK held in direction of flow PSID (1 PSID or more) [] [] 2ND CHECK held backpressure ID [] NO, 2 SHUTOFF VALVE leak tight I;3 [] ?_ND CHECK hzld in direction or flow __. PSID (1 PSID or more) [] Passed Failed ANTI.SPILL VACUUM BREAKER: Passed Failed Differential pressure across check was PSID (1 PSID or more) [] [] Air inlet star~ I:o open at PSID (l PSID or more) [] O Air )nlet ~ull,/ ogen when supply pressure atmospheric [] [] NOTE: Failure of any of the above items, requires repair, FINAL TEST AFTER REPAIR PRESSURE VACUUM BREAKER; Passed Failed Internal check held tight in direction of flow PSID (1 PSID or more) L:I [3 Inlet Poppet opened at~ PSID (1 PSID or more) [3 [] FINAL TEST AFTER REPAIR ANTI,SPILL VACUUM BREAKER: Passed Failec Differen[ial pressure across check was PSID (1 PSID or more) [] D Air inlet start Co open at PSID (1 PSID or more) [] O Air inlet fully open when supply pressure atmospheric ~ COMMENTS REPAIR HISTORY THE ABOVE REPORT IS CERTIFIED T~ !~E TRUe;, ACCURATE--- AND COMPLETE. -tF ~ Signature Oa~e Te~ce~ ey: [PrlnU AAA Mechanical Contractors, Inc. ~_. gm-- ~gX 8 0 ] , .Iowa City o~96_ _ 319/351-1843_ · Date TnTQI 13 DIA MAR-O?-2002 10:47 AAA MECHANICAL CONTRACTOR 13193510?4? )ACKFLOW PREVENTION ASSEMBLY TEST DATA AND MAINTENANCE REPORT CUSTOME~ [ ClJ:~TQM~.,q NUMe~ i II1~. NUIm~;.q P.01704 (IN./F'T.J TmM~ I~A.M. ;, 5;50 MANUFACTURER, SUPI~.Y PRESSURE MODEL IMETER NMMSER P~OTECYtON FROM; FR;I~71NG ~ YES [] NO RLOOOiNO ~ Y~S [] NO SUPPLY ~,~..~ IN. GAP "~ iN. INITIAL TEST REDUCED PRESSURE PRINCIPAL ASSEMBLY: 1ST CHECK held in direction of flow RELIEF VALVE opened et OIFFERENCE (1 st check - relief) _~__ PSID (5 PSID or more) ~. ~.. PSID (2 PSID or more) . PSID {3 PSID or mere) 2ND CHECK held backpressure NO. 2 SHUTOFF VALVE leak tight 2ND CHECK held in direction of flow ~ PSID (1 PSID or more) RELIEF VALVE exercised to full open position Passed Failed FINAL TEST AFTER REPAIR Passed Failed REDUCED PRESSURE PRINCIPAL ASSEMBLY: [] 1:3 1ST CHECK held [n direction of flow ~ PSID (5 PSID or more) [] 1:3 RELIEF VALVE opened at __. PSID (2 PSID or more) El O DIFFERENCE {1st check - relief) PSiD (3 PSID or more) [] j El 2ND CHECK held bach, pres'sure E! [] NO. 2 SHUTOFF VALVE le~k tight [] 2ND CHECK held in direction of flow ~ PSID [1 PSID or more) [] 13 RELIEF VALVE exercised to full open position [] [] [] 0 C] [] NOTE: Failure of any of the above items, requires repair. FINAL TEST AFTER REPAIR Passed Failed DOUBLE CHECK VALVE ASSEMBLY: Q E~ 1 ST CHECK held in direction of flow PSID (1 PSID or more) [3 [] 2ND CHECK held backpressure [] [] NO, 2 SHUTOFF VALVE leak tight [] [] 2ND CHECK held in direction of flow PSID (1 PSID or more) [3 [] INITIAL TEST Passed Failed DOUBLE CHECK VALVE ASSEMBLY: 1 ST CHECK held in direction of flow PSID (1 PSIO or more) c3 [] 2ND CHECK held backpressure [] [] NO. 2 SHUTOFF VALVE leek tight El [] 2ND CHECK h-Id in direction of flow PSID (1 PSID or more) Cl n NOTE: Failure of any of the above items, requires repair. INITIAL TEST PRESSURE VACUUM BREAKER: Passed Internal check held tight in direction of flow PSID {1 PSID or more) [] Inlet Poppet ooened at~ PSID [1 PSIO or more) ~ NOTE: Failure of any of the above ]terns, requires repair. APPROVED APPUCA T/ON5 0NL Y Failed APPROVED APP?.../CA 770NS ONLY FINAL TEST AFTER REPAIR PRESSURE VACUUM BREAKER: passed Failed Internat check held tight in direction of flow PSID l1 PSID or more) [] [] Inlet Poppet opened at __ Pale {1 PSID or more) I~ Et FINAL TEST AFTER REPAIR iNITIAL TEST ANTI-SPILL VACUUM BREAKER: passed Failed Differential pressure acre55 check was PSID (1 PSID er morel [] [] Air inlet start to open at PSID (1 P$ID or more) D [] Air inlet fully open when supply pressure atmospheric [] [] ANTI-SPILL VACU'UM BREAKER; Passed Failed Differential pressure across check was PS[D (1 PSID or more) ~] [] .a,i~' inlet start to open at . PSID ~1 PSID or more) [] O Air inlet fully open when supply pressure atmospheric [] [] NOTE: Failure of any of the above items, requires repair. COMMENTS MEPA,n HISTORY - THE ABOVE REPORT IS CERTIFIED TO BE'~UE, ACCU~T'E AND COMPLETE. , Mike Jones /~~ ~~- ,~ AAA Mechanical Contractors, In.c.P.O. Box 8051 Iowa Ci.t¥ 0296_ Phone