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HM A. AU FEMME dba T &R Building Services w y . 8660 Rogue Lane. Wilsonville, OR 97070 6 (503) 318 -6313 FAX (503) 682.4466 CCU 116054 EW r evs -AwwA BACKFLOW ASSEMBLY TEST REPORT ❑vE.D N IL • Oltitre QN�- la �,,,I PHONE. ' 0 lt�rLA +rr grN R: tat AL 011011 1E s a UUNG **�� CITY STATE TIP rnREjs: /S2o9 se,./ Sew kit 64, UIek1 Rct STREET MBA. I3D.CV.A. ❑RPDA ❑D_C.DA. 0P.VB.A. ❑S_V_R_A. ©A.V•B. 13 AIR GAP cm ZE: Lakil gl MAKE: 6YWl g.'..1 A ni a Z 6 00 ak m tiTER -..- SERIAL RVEYOR: i J _ L5 A � k j d 1 q 53 SF1dIIL : l N PI �:� C'� V • A L( CATION: REDUCED PRESSURE ASSEMBLY ` P_V ILA. I S.V.aA. INITIAL TFST w C R M : DOUBLE CHECK AIR CHECK PASSIM te Puss DROP M1 in INLET FA IUD RH170:36! r • E f 2. OMER AT ' rirm oRW' flAL �a KY, � 4 'ESr ' DATE . rsD • LEAKED 0 PER) TE 0 BUF E /1 g111T$ A - n CHICK PAD rsin - t�• rsl x RELIEF VALVE • : 116111- � BID NOT HAILED SYSTEM IL CC P la FAIL p fI.CAKID OPEN ❑ p PSI awn te mot U) I I= - J 3E171.CT.17 RU;SIWtEdk'SF.FIM.Y . t ® noCEcx wi I) P.v,BA. / S.Y.B.A. UAAf REPAIRS • MESS oar i E :7EEr RAF • L71EL7C AI Ov rnr Pans MN , • .moo ,�, r Miff pm* I co E'Ar s , w�, wo ; Bs CriL+Gtc 82 Q '■.,r1. !Tian' 0 rsrn rstD rsv , PASSED El eL E J1CO53P E ANOANDSURif3TRKCR7 lO'iTESTRf7'ORETBR TESTERCTiRm fS7I.srm1 If In p AGSM PEP HAS DHJN 713 LYrnAATMA03TAitren n. 4CY]*Th,. ',PPM AlL5P5LICABIE 0 ARESANO L JL%1RD.'6 01 ME 9KRFJt SYS1EK, AND WOE REGUUuuOr6. NI UCE CALIBRATION D.YI E 1 rA w L R MSR READING a 3466 o r.. MI ""`"" TIM A. AUFENTHIE CENT N N o rats ?Wilt ""'" Wilsonville, 8660 Rogue Lone. OR 97070 (5 313 $ 6313 • o rkxt wmsO T & : - • r1R7ht • CO N 1131yY row _ • g Ad . + _.• I _� 1 u (l' SERVICE R D O Z I11WAVED R o : :4 1 •OWNER) J • Z A.