RPBA test report.pdfNEW INSTALL% EXIS'T'ING REPLACEMENT i 1 REMOVED OI.D SER.#
APPROVED ASSEMBLY? YES V NO PROPER INSTALLATION? YES V NO
MAKE OE ASSEMBLY BMODEL-LO—SERIAL NO. _SIZE
AIR GAP INSPECTION: SUPPLY PIPE DIAMETER SEPARATION PASS: FAIL
DETECTOR METER READING
LEFT SERVICE AS FOUND Isolation valve: Open Closed SOV#1 Open Closed SOV#2: Open Closed
REMARKS: 15
TESTERS SIGNATURE:
- LINE PRESSURE _� PSI CONFINED PCE? No
CERT. NO, B5046 DATE
I certify that this report is accurate, and I have used WAC 246-290490 approved test methods and test equipment.
DCVA / RPBA
DCVA / RPBA
RPBA
PVBA I SVBA
INITIAL,
CHECK VALVE NO.1
CHECK VALVE NO.2
AIR INLET'
TEST
OPENED AT_
_PSID
CLOSED TIGHT
CLOSED TIGHT,,X
OPENED AT � PSID
PASSED
#.1 CHECK
' SID
LEAKED
LEADED
_ _.
FAILED
AIR GAP OK?
DID NOT OPEN
PSID
PSID
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
�.-�-�---w
PASSED �I
�
FAILED '::....1
PSID
PSID
#I CITE CK �!, J_PSID
CHK VALVE ��. PSID
AIR GAP INSPECTION: SUPPLY PIPE DIAMETER SEPARATION PASS: FAIL
DETECTOR METER READING
LEFT SERVICE AS FOUND Isolation valve: Open Closed SOV#1 Open Closed SOV#2: Open Closed
REMARKS: 15
TESTERS SIGNATURE:
- LINE PRESSURE _� PSI CONFINED PCE? No
CERT. NO, B5046 DATE
I certify that this report is accurate, and I have used WAC 246-290490 approved test methods and test equipment.