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Test reports from BATMASTER ABC Water Specialty 09-30-21BATMASTER / ABC Water Specialty 425-397-0275 2918 Cavalero Rd Lake Stevens, WA 98258 BACKMOW EXISTING 8REMOVED PREVENTER REPORT NEW REPLACED REPAIRED OLD SIN: PROPF.RTYNAME Thrive Kid Dentistry PHONE 310-982-8557 CONTACT NAME Mike PHONE MAILINGADDRESS 10032 Edmonds Way CITY Edmonds STATE WA zip 98020 PREVENTF.RADDRESS 10032 Edmonds Way Edmonds, WA 98020 WATERSUPPLIER Edmonds Public Works SERIAL# 285461 LOCATION In Mechanical Room MAKE Watts MODEL. LF009QT sizE 1/2" TYPE ® RP 0 RPDA RPDA-H ❑ DC ❑ DCDA ❑ DCDA-II PVB EDSVR AVR 0 AG HAZARDPROTECTED PREMISES ISOLATION IRRIGATION FIRESYSTEMEl BOILER ® OTHER Dental Vacuum APPROVED: ® ASSEMBLY [K INSTALLATION ® ORHwrAT10N ❑ ABRGAP PIPES17R in ,. R,1� in REDUCED PRESSURE ASSEMBLY PVBAJSVBA INITIAL TEST DOUBLE CHECK AIR INLET CHF,CK VALVE PASSED CHECK#1 CHECKgI TYPE II ❑ oPEPIEIAM PRIMORM: PRESS 8.0 TIGHT © FAILED UROP: INITIAL MINSPSID TEST RELIEF RESULTS OPONEDAT: MIN2PMD RELIEF VALVE: PASSED ® PARAD NOTES REPAIRS PARTS I rwrnn � Mav I rsat MIN 1 PsID OPENED CHECK FULLY TIGHT ® DID NOT LEAKED ❑ Ma! 1 PsID OPENa MIN I PEID l DATE FAILED SYSTEM PSI y 1 u DFTF,CTOR METER READINQ REDUCED PRESSURE ASSEMBLY PVBA/SVRA TEST CHECK #1 DOUBLE CRECK AFTER REPAIRS PRESS DROP: _ CHI19 TYPE. AIR INLET CIIECK VALVE REPAIR MIN51SID TIGHT ❑ OWNED AT: PRL'SSDRON RESULTS RELIEF VALVE DATE OPRNF.D A1` CHECK #2 Mm I PRm MIN 1 KID MIN I PSID aR1,1xFvu.vx MlNzPalo TIGHT �1Y PASSED PASSED ❑ FARAD ❑ 142111Mm GAUGE SIN 02062045 MAKE/MODEL MIDWEST INSTRUMENTS 845-5 CALIBRATION DATE 12-22-20 In completing and submitting this test report, the tester certifies that the assembly was tested and maintained in accordance with all applicable INITIAL TEST TEST AFTER REPAIRS (� C 6482 TP.3 SIGNATURE Cod Gobbato TESTER SIGNATURE TESTER CF.RT # 425-397-0275 'IL+STER NAME (PRINTED) 2918 Cavalero Rd Lake Stevens, WA 98258 TESTERNAME (PRIMIT.D) PHONE # batmaster@backflowservice.ne TESTER ADDRESS BATMASTER / ABC Water Specialty TESTER ADDRESS EMAIL COMPANYNAME COMPANY NAME ®WATER RESTORRD'1 © FOUND OFF, LFFT OFF MORTREMn EDBY(RLPMENTATIVROFOWNBR) REpORritHcmVIi nyou PRFSLPrrAT/vL+OPOwNER) BATMASTER / ABC Water Specialty 425-397-0275 2918 Cavalero Rd Lake Stevens, WA 98258 BAG"KMOW EXISTING 8REMOVED PREVENTER REPORT NEW REPLACED REPAIRED OLD SIN: PROPF.RTYNAME Thrive Kid Dentistry PHONE 310-982-8557 CONTACT NAME Mike PHONE MAILINGADDRESS 10032 Edmonds Way CITY Edmonds STATE WA zRP 98020 PREVENTF.RADDRESS 10032 Edmonds Way Edmonds, WA 98020 WATERSUPPLIER Edmonds Public Works SERIAL# 229594 LOCATION In Mechanical Room MAKE Watts MODEL. LF009M2QT SIZE 1" TYPE ® RP 0 RPDA RPDA-H ❑ DC ❑ DCDA ❑ DCDA-II PVB ED SVREIAVB 0 AG HAZARD PROTECTED ®PRBMISES ISOLATION IRRIGATION FIRE SYSTEM BOILER ❑OTHER APPROVED: ®ASSEMBLY INSTALLATION ®OR11771'AT1l7N ABRGAP PIPE SI7E in> yl� in REDUCED PRESSURE ASSEMBLY PVBAJSVBA INITIAL TEST DOUBLE CHECK AIR INLET CBFCK VALVE PASSED CHECK#1 CHECK#I TYPEII ❑ oPENauwr. WFasnRor: PRESS 8.6 TIGHT © FAILED DROP: INITIAL MINSPSID TEST RELIEF RESULTS OPnNEDAT: MIN2M1D RELIEF VALVE: PASSED ® PARAD NOTES REPAIRS PARTS 1 rwrnn � Mar I rsat MIN 1 PsID OPENED CHECK FULLY TIGHT ® DID NOT LEAKED ❑ Mn! I MID DPI a MIN I PEID I DATE FAILED SYSTEM PSI y 1 u DFTF,CTOR METER READINQ REDUCED PRESSURE ASSEMBLY PVBA/SVRA TEST CHECK #1 DOUBLE CRECK AFTER REPAIRS PRESS DROP: _ CBS 19 TYPE. AIR INLET CIIECK VALVE REPAIR MIN51SI. 'TIGHT ❑ OWNED AT: PRL'SSDRON RESULTS RELIEF VALVE DATE OPRNF.D A1` CHECK #2 Mm I PRID 1,1011 KID MIN I Pan, aR1,1xFvu.vx MlNzPalo TIGHT �1Y PASSED PASSED ❑ FARAD ❑ MRr1Pam GAUGE SIN 02062045 MAKE/MODEL MIDWEST INSTRUMENTS 845-5 CALIBRATION DATE 12-22-20 In completing and submitting this test report, the tester certifies that the assembly wits tested and maintained in accordance with all applicable INITIAL TEST TEST AFTER REPAIRS (� C 6482 TP.3 SIGNATURE Cod Gobbato TESTER SIGNATURE TESTER CF.RT # 425-397-0275 T ESTRR NAME (PRINTED) 2918 Cavalero Rd Lake Stevens, WA 98258 TESTERNAME (PRINIT.D) PHONE # babmaster@backflowservice.ne TESTER ADDRESS BATMASTER / ABC Water Specialty 'TESTER ADDRESS EMAIL COMPANYNAME COMPANY NAME ® WATER RESTORBD'I © FOUND OFF, LEFT OFF ItIiPORTItEMn EDBY(RLPMENTATIVROFOWNBR) REpORritHcm Ii nyou PRFSLPrrAT/vL+OPOwNER)