RPZ 09/2024Interstate Testing, LLC
P.O. Box S5
Anoka, MN 55303
(763) 744-6149
interstatetesting0comcast, net
Backflow Assembly Test Report
(RPZ, DCVA, PVB, SPVB,)
City
Frid
Property/Owner Information
Property Name:
Jim or Susan McGuire
Property Address:
Address:
lFridleyMN
7068 Hickor Dr,
City-
State:
Zip:
55432
Property Contact/Phone#:
Name,
Phone;
Jim McGuire
763 291-6143
Property Owners AddresS:
Address:
7068 Hickory ❑r. Fridley, MN 55432
city..
State
7AP:
Fridley
MN
55432
Property Owner/Phone #:
Names
Phone:
Jim or Susan McGuire
763 291-6143
type of Assembly/Work Performed
RPZ
PVR
SPV8
DCVA
Test Re alr RB
I Test-XLTest-2L Re air, RB
Test Re r.;,, RIB
Test —Repair R8 _,
Backflow Assembly Information
Size:
Flake:
Model:
Ser1w M
En2m 5ervtced:
1"
Febco
765-1
H163481
Irrigation
Location of Assembly: Back of house
Backflow Assembly Test Results -
Type of
Check Valve #1
Shut off Valve #2
Rehef Valve/
Check Valve #2
Assgenbl
Air Inlet Valve
�
Closed__—
Openppen
_. __ Closed _ _..
b erred at ._ _
p psid
Open Closed
Pressure filltl., ,�_� pod
oldaotapeu
DCVA
Opel'— Closed
Open Closeed,,,.____
Upeu Closed
Prcxtiureilii - .psid
Pressure V— -- _ psid
PVR/SPVSOpen
— Closed..,X _
openwat 44.55 pstd
Open Closed X
Pressure fllff, 2.4 paid
ILIA not open �.,.
Comments:
PASS„�,X _
Tester's Nance:
Donn Miller
Tester's Information
Tester's Signature:
Certification Date:
BF065323 �09-04-24