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] FIRE ,,FETY SYSTEMS
., i f .,:i' ': L� �/` � AQUAS FET" FLOW TEST
: VE. IFICATION
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� A a AAE Flow TestVerification I no.
Alliance important- Installing must this
Member ID: completed form,Failure to '.f so nullifies the
/1 r �warranty,E-mail or form
Company Mame, Ai 1.cote ...0. _....,„_...
to the ►or»re ' .,. ung
Contact D*414A+►a`k. attechnicar 'cornor952.997.1731.
For'modicum_contact U , Technical Services at
Phone: X)l' 'OA--* 1.15° aeas 4 725 or technical 'eesaluponortes
Fax._ Color st orifice used: c
Job Name: v1tf-Itf'C Static pressure(not flowing) ..sing at incoming/
Project Number: 1+4 2••'rS.l�.t-77
rf water supply into home or at'airs shutoff,
tTJ a) ?W ti�icL[t t{
fob Address: e"yx t.
.�-}� Residual pressure(flowing)r +:ng at incoming,
City: i) supply into home or at main •,utoff: f
State,ZIP: f3 t.
r What time of day was the Flo test taken? 2."
For designs not provided by Uponor,complete theFlow test method used? ket 0 Flow Meter
following information, h3
Designer's Name: . ,'4 I IL Flow test gpm: P r
Company; r16✓�` How many gallons of water d the design predict
g� as required? I'd j
Phone: l7.r ,e:To
Did the test meet or exceed s° ign' flow? ad Yes 0 No
Fax: Which sprinkler did you flow. 'umber 11.1
„, Is the warning sign per at ed dose to the Lo of head ' a
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dr
A 1 ft"+ main shutoff valve? 1 No •
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r Date left in service with all v. es open: / `q
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Was this system required by code?ld'Yes 0 No
„ s. ....
E Test Witnessed and Verified by
QN Signature
on �t_ YJsl )e
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AdditionalExplanations and Notes I
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Uponor,,inc. Tel:800.321,4739
1 5925 148th Street West Fax:957.997.1731 y'
Apple Halley,MN 55124 USA Web: ++wuponor-usa.cam
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