HomeMy WebLinkAbout3/27/2002 bfp955mormontrekMar I2 02 07:31a Lares Co.
IUWA CITY - PUBLIC DRINKING WATER PROGRAM
8ACKFLOW PREVENTION ASSEMBLY TEST DATA AND MAINTENANCE REPORT--
INITIAL TEST
REDUCED PRESSURE PRINCIPAL ASSEMBLY:
IST CHECK held in
direction of flow . ~- PSIO
RELIEF VALVE
opened at ~ PSID
I1 et check - reliel) PSID
2ND CHECK held bac~pres~ure
NO. 2 SHUTOFF VALVE leak tight
2NO CHECK held in ~
direction of flow~ PSID (1
RELIEF VALV~ exercised to full open ~osltion
NOTE: Failure of any of the above Items, requires
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Failed FINAL TEST AFTER REPAIR Pesaod Failed
o REDUCED PRESSURE PRINCIPAL ASSEMBL¥: y []
[] direction of flow o PSID (5 PSID or moral / []
RELIEF VALVE
n opened at d~ F$1D (Z P$1D or mom) ~
DIFFERENCE
n l1 st qheck - relief) PSID (3 PSID or more) ~ []
El 2ND CHECK held backpressu~o / n
El NO. 2 SHUTOFF VALVE leak tight /
2ND CHECK held in
~ direction of flow .~,~,._.4~._ PSIO Ii P$1D or morelc,l~-_
~ RELIEF VALVE exercised to lull open position ~
INITIAL TE~T Passed Failed
OOUBLE CHECK VALVE ASSEMBLY: []
I ST CHECK held in
d;reclion of flow PSID {1 PSID or more) rl 13
2NO CHECK held backpressure []
NO. 2 SHUTOFF VALVE leak tight [] O
~ND CHECK held in
direction el flow PSID {I PSID or mom) [] O
NOTE: Failure of any of the above Items, requires repair.
INITIAL TEST APPI~OVEO ,4£PLIC/I TION$ ONLY
PRESSURE VACUUM RR~KER: Pa~sed Failed'
Internal check held tight In direction of flow
PSIO [I ~SID or moral a a
Inlet Poppet opened at~ PSID
(t PSID ar morel ~ ~
NOT~: Failure of any of the above Items. requires repair.
APPIIOVEO AP°UCA TION$ ON[ Y
INITIAL TEST
FINAL TEST AFTER REPAIR Passed Failed
DOUBLE CHECK VALVE ASSEMBLY: 13 o
1ST CHECK held in
direction of flow PSID (1 PSID or morel ri []
2ND CHECK held backpressure Fa n
NO. 2 SHUTOFF VALVE leak tight [] ri
2ND CilECK held In
direction of Ilow PSIU (1 PSID or more) El El
FINAL TEST AFTER REPAIR
PRESSURE VACUUM BREAKER.' Passed Felled
Internal check held tight in direction of flow
PStD il PSI[:) or morel n n
Inlet Poppet opened at ~ PSIO
(1 PSIO or more) ri []
FINAL TEST AFTER REPAIR
ANTI-SPILL VACUUM BREAKER: Passed Failed
Differential pressure across check was
PSIO il PSID or morel O 13
Air inlet start to open at -- PSIO
11 PSIO or more) El 0
Air inlet ItJIly open wh,en supply pressure
atmospheric [] []
NOTE: Failure of any of the above items, teqoires repair,
ANTI-SPILL VACUUM BREAKER.'
OiHerential pressure across check was
PSID (1 PSIO or morel
Air inlet start to open et -- PSIO
(1 PSID or more)
Air inlet Jully open when supply pressure
atmospheric
Passed Failed
[] 0
[] I-1
n []
'~{E A~E REPORT IS CERTIFIED TO BE TRUE, ACCUflATE AND COMPLETE.
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Oat~
Mar 12 02 O?:31a Lares Co. Inc. 319-337-7636 p.3
IUWA CITY - PUBLIC [DRINKING WATER PROGRAM
;Em,~CE t. 0CA rl0fl
i TiM$~L ri A,M.
INITIAL TEST Passed Failed
~EDUCED PRESSURE PRINCIPAL ASSEMBLY: ~
I ST CHECK held in
direction of flow~ PSID (5 PSID or more) ~
opened ~t , PSIO 12 PSID or more)
DIFFERENCE
list check - relief) J,TPSID (3 PSID or more)
2NO CHECK held backpressure
NO. 2 SHUTOFF VALVE leek tight
2NO CHECK held in
direction of flow PSID I1 PSID or more)
RELIEF VALVE exercised to full open position
NOTE: Failure of any of the above Items. requires repair.
INITIAL TEST Passe~ Failed
DOUBLE CHECK VALVE ASSEMBLY:
I ST CHECK held in
direction of flow FSID (1 PSID 0r more)
2~0 ~H~CK held backpressure
NO. 2 SHUTOFF VALVE leak light
direction of flow PSID (I PSID or mote)
NOTE: Failure o; a~y ~ the above Items, requires repair.
INITIAL TEST APPROVEO APPLICA TIONE ONlY
PRESSURE VACUUM BR~KER: Passed Failed
In~crnal check held tlgh~ In direction of flow
PSIO ~1 PSIO or more)
Mlet Poppet opened at ~ PSID
II PSID or more) '
NOTE: Failure of any of the above items, requires r;palr.
INITIAL TEST APPROVED ~PP&ICA TIONS ONLY
ANTI-SPILL VACUUM BR~KER: Passed Fa;led
Differential pressure across check was
PSID II P~ID or more)
Air inlet start to open at PSIO
(I PSIO or more) ~
Air inlet ~ully open when =uppIy pressure
atmospherio ~
NOTE: Failme of any el the above items, requires repair.
CUSTOMEtrl NUMBER
IFIL~ NUMeER
iMETER NUMGER
-,un.tv ! ,-,. n^. ~ ,., El FA..
SIZE
~OtMMENrS:
FINAL TEST AFTER REPAITt Passed
REDUCED PRESSURE PRINCIPAL ASSENIBLY:
ISTCHECKheldin ?,~j[
direction of flow ~ PSID (5 PSID or more) i. JY/ n
RELIEF VALVE
opened at --~a~. PSID (2 PSID or mare) /~ []
DIFFERENCE Z~
(Iai check - relief) IZ-,-PSID (3 PSID or moro) []
2ND CHECK held backpressure []
NO. 2 SHUTOFF VALVE leak tight ~
2ND CHECK held in /
direction of flow ~o2-PSID (1 PSID or more) ~
RELIEF VALVE exercised to full open position ~ El
Failed
FINAL TEST AFTER REPAIR Passed Failed
DOUBLE CHECK VALVE ASSEMBLY:
1 ST CHECK held in
direction of flow ~ PSID [1 PSID or morel [] []
2ND CHECK held b~ckpressure []
NO. 2 SHUTOFF VALVE leak tight O []
2NO CilECK held in
directio,t of flow PSID {1 Paid or more} El El
FINAL TEST AFTER REPAIR
PRESSURE VACUUM BREAKER: Passed Failed
Internal check held tight in direction el llow
Paid (1 PStD or more) O n
Inlet Poppet opened at~ PSiD
{1 PSIO or more) El El
FINAL TEST AFTER REPAIR
ANTI-SPILL VACUUM BREAKER: Passed Failed
Oir(erential ore~ure across check was
~ PSIO (1 PSIO or morel 121 n
Air inlet start to open at __ PSIO
(1 P~IO or more) El []
Air inlet fully open when supply pre, sure
atmospheric 0 O
COMMENTS
REPAIR HISTORY
rile ABOVE REPORT IE~ CERTIFIED TO BE TRUE, ACCURATE AND COMPLETE.
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