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Ed Prof Center BAT reports rec'd 2-8-08.pdf02/0812008 09:39 3606713787 BLYrHc BLYTHE PLUMBING err r� r� w� � �� ■ r r r:: ur �. � irr�r��ti � PLUMBING E�- 1 -SEATING. INC. Serving the Northfoesr since 1904 MECHANICAL CONTRACTORS FAX TRANSMITTAL SHEET DATE: 02/08/08 TO: City o1F1-7dmonds FROM: Dawn Hayes RF,: Backflow test reports FAX NO: (425) 771-0221 ATTN: Ann Bullis TOTAL 4 OF PAGES: 3 PAGE 01/03 COMMERCIAL. INOuSTRIAL Here are the two backflow test reports for the Edmonds Professional C cater. Please let Azle know if you have any questions. Thank you, Daihm Hayes Service Coordinator 360-733-7810 2201 i-lurnholdt Street i seiiinelatin, WA 98225 1 Phone: (360) 733-7810 1 Fax: (360) 671-3787 E-mail; EIYI!LC@Blytiieine.com i,eine.com Web: ww,,.Blvtlieinc.Sotn I Contractor Number: 13LY7'141*235L0 02/08/2008 05:39 3506713787 BLYTHE PLUMBING BLYTHE PLUMBING & HEATING, INC. BACKFLOW ASSEIMBLY TEST REPORT ME8111HOW 2201 HUMBOLDT STREET BELL.NGHAM, WA 98225 PFI: (360) 733-7810 FAX: (360) 671-3787 NKME: SERVICE ADDRESS: , LOCATION OF ASSEMBLY: I"'�� `� — `L CROSS CONNECTION FOR: ASSEMBLY: MAKE, MODEL SITE TYPE S PAGE 02/03 New Existing Lam` Replacement u �1Ulv1BER IS THIS A PREJYLK INN AALLAAkU1v! Yes iNo �- Water Service Found: On Al—, Off Water Service Left: On OSE REMARKS. Test Equipmertt: Make -Serial# ��" ::fes Accuracy Verification Date -� -` ?•' •% Assembly Tested: Satisfactorilyy'Failed I CERTIFY,THE ABOVE REPORT;' TO BE TRUE; _ 77 CertiftsdlTcmm Typed or Printed N.-Lrne - Phone No ITl7ttaleSt By. ly. w f ^_ Cert. No. i mate Signantrc Repaired By: Date Repair Test. By: Sitmamrc Bttckflnw Ttst Form (6/02) White: citycopy Cert No. Yollow; Gist—er Cony Dare Pink: Tcstor Copy INITIAL TEST RESULTS TEST AFTER REPAIR OR CLEANING Line Pressure psi Pressure Drop Across Pressure Drop Aoross No. I Check. Valve (A) `'. psid No. I Check Valve (A) psid Relief Valve Opened (13) ,G - -12-- psid Relief Valve Opened (B) psid ,BA No. 1 Chec1c Closed tight...s/ No. I Check: Closed tight.: c Leaked......... n Leaked.......:. a + No. 2 Check: Closed tight...s- No. 2 Checic: Closed tight. ..❑ Leaked ......... a Leaked...... , . , n Minimum AG Separation' Yes e,-- Minimum AG Separation Yes No Passed Test Yes „/Na Passed Test Yes No Lime Pressure psi No. I Check: Closed tight ... ❑ psid No. I Check: Closed tight ... ❑ psid DCVA Leaked ......... 4.0 psid Leaked ......... ❑ psid No. 2 Check: Closed tight ... ❑ psid No. 2 Check: Closed tig%7 _ -0 psid Leaked ......... a psid Leaked ....... __ psid Passed Test Yes No Passed Test yes. No Line Pressure psi Air Inlet: Opened psid Air Inlet: Opened ' psid *PVB Nailed to open ❑ Failed to open ci Check Valve: psid Check Valve: psid Leaked .......... o Leaked .......... ❑ Passed Test Yes No Passed Test Yes No AG k ,ASE, RECORD REPAIR OR CLEANING MORMATION I j Minimum Separation Yes No IN 'REi41AREC5" SECTION BfriA W IS THIS A PREJYLK INN AALLAAkU1v! Yes iNo �- Water Service Found: On Al—, Off Water Service Left: On OSE REMARKS. Test Equipmertt: Make -Serial# ��" ::fes Accuracy Verification Date -� -` ?•' •% Assembly Tested: Satisfactorilyy'Failed I CERTIFY,THE ABOVE REPORT;' TO BE TRUE; _ 77 CertiftsdlTcmm Typed or Printed N.-Lrne - Phone No ITl7ttaleSt By. ly. w f ^_ Cert. No. i mate Signantrc Repaired By: Date Repair Test. By: Sitmamrc Bttckflnw Ttst Form (6/02) White: citycopy Cert No. Yollow; Gist—er Cony Dare Pink: Tcstor Copy 02/.08/2008 69:39 3606713787 BLYTHE PLUMBING PAGE 03/63 BLYTHE PE.t.;KRINt.+ S HEATING. INC. BAc,KF.LON ASSEM>1 LY TEST REPORT 2201 i-IUMBOLDT STRE.LT T�4=I..L.INC"r1lAt<!f, ',�l 95-�; PI -1-060)'73-i-7810 F'AX (360) h71•:,7N7 EXIStin" L Replacement r - NA ME:��N�c'rl�.�G� ST_RN7jC- ADDRESS: LOCATION OF ASS.EIN7KY: CROSS CC)NNF,C"T10N FOR: - ASSEMBLY: MAKE MODEL,. SIZE TYPT, SLRIAL NUMBER 13 THIS A FKOFEK INJ J AE..LA I JUN.' 7 C5 y INO Water Service Found: On oft•' / Water Service Left: On Off ✓ REMARKS: _.. jle��{t� Tact i.n:linment:: Make lNIiW,�S-r-Model � Ju Sel-ial � Accuracy Vori�l�tc�.tlpll Tate L1 '4 07 Assemhly Testcd: Satisfactorily-_. Failed I CERTIFY THF, ABOVE REPORT TO BE TRUE: c�JG �, � • 733 � 78 ro C uEificd Teslas Tj�c sr N2 nlc P11 me No Initi<ll Test By; _ j �_ Cert. No. ,&. 5ZVO Date Ok7� Si�naturr Repaired By Repair Test By: _ _... Signalun• Date C'erl Net. _Date 733ck11mA-'T"-1P01m f4S10_1 whim 01y Copy Yellow•(:xm tncrCol,v Pinks T'e e"(7nls)• INITIAL TEST RESULTS line Pressure psi TEST AFTER REPAIR OR CLEANZNG77 Pressure Drop Across Pre -sure Di-(gi Across No, l Check Valve (A) ., L` psid No. I Check Valve (A) . _... .. psid Relief Valve Opened (R) �, Z_ p;id Relief Valve Opened (B) psid RPBA _ No. 1 Chcck: Closed tigllt...lY No, l Check, Closed tight.,.. Leaked ......... ❑ Lcaked... • . • ., . ❑ No. 2 Check: Closed light. ..er'� No. " ChecJr: Closedtight.,,o Leaked......... o Leaked. • ... , , .. o Minimum AG Separation Yea ✓ No _ Minimum AG Separatiol) Yes No Passed Test YEs =No Lille Pressure Psi Passed Test Yes Nn No. I Check: Closed tight ... 0 psid No. I Check; Closed tigltt..,o }psid DCV,, Leaked. ........ o...,... psid Leaked.......,. psid No. 2 Check: Closcd tight ... u p,;id No. 2 Chock; Closed Tight, C) _. „ psid Leaked ......... o psid i Lcakcd......... 0 psid Passed Test Yes Flo Passed Test Yes __ No Line Pressure psi _ _ Air inlet: Opened psid Air lallet; Opened PV$ Failed t0 open ❑ Failed to opera n Check Valve: psid Check Valve: psid ,_ Leaked, .........o Leaked, ...... • .m Passed Test Yes No Passed Test Yes No AG PI.TASE RECORD REPAIR OR CLEANING TNFOTRMAT10N Minimum Separation Yes No IN "REMARK5" S>'CTTUN BELOW 13 THIS A FKOFEK INJ J AE..LA I JUN.' 7 C5 y INO Water Service Found: On oft•' / Water Service Left: On Off ✓ REMARKS: _.. jle��{t� Tact i.n:linment:: Make lNIiW,�S-r-Model � Ju Sel-ial � Accuracy Vori�l�tc�.tlpll Tate L1 '4 07 Assemhly Testcd: Satisfactorily-_. Failed I CERTIFY THF, ABOVE REPORT TO BE TRUE: c�JG �, � • 733 � 78 ro C uEificd Teslas Tj�c sr N2 nlc P11 me No Initi<ll Test By; _ j �_ Cert. No. ,&. 5ZVO Date Ok7� Si�naturr Repaired By Repair Test By: _ _... Signalun• Date C'erl Net. _Date 733ck11mA-'T"-1P01m f4S10_1 whim 01y Copy Yellow•(:xm tncrCol,v Pinks T'e e"(7nls)• FEB/0$/2008/FRI 09:35 Ali JTM CONSTRUCTION FAX No,206-587-4003 CONSTRUCTION To:ANN 10 LL.-� S From: V4 ��rJ1�vS Attention: Pages: Fax: bo—'r)�Date: 2- , 0 � Re: CC: ❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply❑ Please Recycle 0 Comments: AF -Lc:' --a 17, -paw rj -)4riks JTM CONSTRUCTION METROPOLITAN PARK EAST 1730 M I NOR AVENUE, 4U ITE 1120 SEATTLE, WASHINCTON 98101 FEB/..0.8/2008/FRI 09:35 AIS JTM CONSTRUCTION FAX Ido. 206-587-4003 New ❑ BLYTHE PLUNGING &, HEATING, INC. Existing 2, -- BACKFLOW ASSEMBLY TEST REPORT Replacement ❑ ®®S�fl1■®lii� 2201 HUMBOLDT STREET l3ELLINGHAK WA 99225 PII: (360) 7S3-7810 FAQ;: (360) 671-3757 NAME: 2r_rcd i q SFR VZCF ADDRESS: L•OCATIO14 OF ASSEMELY: CROSS CONNECTION FOR: Wf,-'ft ASSEMBLY: 4° t MAKE MODEL SIZE TYPE SERIALNUMBBR 1S TIES A FRUPI~X I NS"d'ALL.ATIOM Yes t/ No Water Service Found: On Water Service Left: On _A�foff RElPARKS, _�—J��rPS) if n i a ,. a A. .. t 1 TestEquipmmeaz: Make of - oda! AEO Smial # Accuracy Verification Date , Assembly Tested: Satisfactorily _r/ Failed I CERTIFY THE ABOVE REPORT TO BE TRUE: Cartifed Testers Typed Pruned Stine Initial Test By: 6 signacnre Repaired By Picone No Cert. No. Date Rate Repair Test By: Cert No. Date Sigpetust Bee-- ow Test Farm (6102) White: City Capy Yellow: Customer Copy Pink; Tearer Copy INITIAL TEST RESULTS TS TEST AFTER RE, PAIR -OR CLE G Line Pressure psi PrCssum Drop Across�I No. I Check Valve (A) '3,4 paid Pmsurc Drop Across No. 1 Check Valve (A) paid Relief Valve Opened (B)!G paid Relief Valve Opened (B) psid RPBA No. I Check; Closod tight... No. 1 Check: Closed tight...❑ Loaked......... ❑ Leaked......... ❑ No.2 Cluck: Closed tight... u/ No.2 Check- Closedtight•..❑ "Leaked ......... a Leaked ......... ❑ Minirnuin AC Separation Yes e,,�o Minjm= AG Separation Yee. No Passed Test Yrm =IN' 0 Passed Test Yes No Line Pressure psi No. 1 Check: Closed tight ... ❑ psid No. 1 Chock: Closed tight... a psid DCV.A Leaked ......... o psid Leaked ......... ❑ psid No. 2 Check: Closed tight... ❑ psid Na. 2 Check: Closed tight... ❑ s psid Leaked.,..;....[ psid Leaked...psid Passed Test 'Y'es No Passed Test Yes No y Line Pressure pal Air Inlet: Opened psid Air Inlot: Opened psid PVI Failed to open ❑ Failed to open ❑ Check Valve: psid Cheok Valve: - psid Leaked .......... ❑ Leaked ..... Passcd Test Yes No Passed Test Yes No AGPLFASE Minimum Separation Yes No MCORD REPAm oR GMEANING III ORMATion IN wREMARRS" SECTION BELOW 1S TIES A FRUPI~X I NS"d'ALL.ATIOM Yes t/ No Water Service Found: On Water Service Left: On _A�foff RElPARKS, _�—J��rPS) if n i a ,. a A. .. t 1 TestEquipmmeaz: Make of - oda! AEO Smial # Accuracy Verification Date , Assembly Tested: Satisfactorily _r/ Failed I CERTIFY THE ABOVE REPORT TO BE TRUE: Cartifed Testers Typed Pruned Stine Initial Test By: 6 signacnre Repaired By Picone No Cert. No. Date Rate Repair Test By: Cert No. Date Sigpetust Bee-- ow Test Farm (6102) White: City Capy Yellow: Customer Copy Pink; Tearer Copy