The URL can be used to link to this page

Report (2) ., t - M'ir o30-anMS uponOi IF ' "At I '.i. d FIRE SAFETY SYSTEMS �` AQUASAFETM FLOW TEST a ;, VERIFICATION • FORM 4, AquaSAFETM Flow Test Verification Form Alliance Important:Installing contractor must submit this Member ID: ir)'CroZ completed form. Failure to do so nullifies the Company Name: � c.o>y f�wA.��jc,�� system warranty.E-mail or fax completed form .J to the Uponor Fire Safety Design Department Contact: (/i` 1.3 0Wr-A11-/ at technical.services@uponor.com or 952.997.1731. 4 L3 l��o 1 �� For questions,contact Uponor Technical Services at Phone: 888.594.7726 or technical.services@uponor.com. Fax: / Color of test orifice used: J'fse'` Job Name: p GS/1A k Static pressure(not flowing)reading at incoming Project Number: 3a ?S7 ' V V/ water supply into home or at main shutoff: Job Address: //yQU $..J Gil J ld4_, Residual pressure(flowing) reading at incoming water City: 7T'AAr1 supply into home or at main shutoff: 39' State,ZIP: ©4 What time of day was the flow test taken? g xi AN\ For designs not provided by Uponor, complete the following information. Flow test method used? ❑Bucket Ci3Flow Meter Designer's Name: f VA/s-/ ;3€76,Jed.c 1L Flow test gpm: / Company: (/PC)Nd How many gallons of water did the design predict as required? /7 Phone: Aitik ark S9Y 72c)Ca Did the test meet or exceed design flow? ,l+l�'Yes ❑No Fax: 95a- 12 17.3/ Which sprinkler did you flow? Number: 1 /1 Is the warning sign permanently attached close to the Location of head: Zedrda^^ . — main shutoff valve? ❑Yes ❑No /, �� Date left in service with all valves open: 7"c2I ' I Was this system required by code?LiIYes ❑No Test Witnessed and Verified by: e ' p Occu ation Date , 1441 ,4a` J `o 0 0 0 e T Additional Explanations and Notes i; LLI 0 e Uponor,Inc. Tel:800.321.4739 5925 148th Street West Fax:952.997.1731 LL Apple Valley,MN 55124 USA Web:www.uponor-usa.com N