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Report Si 2 ai? — 00071 UOflO( ,n •L \ FIRE SAFETY SYSTEMS AQUASAFETM' FLOW TEST VERIFICATION - FORN1 AiaSETM Flow Test Verification Form Alliance Important installing contractor must submit this Member ID: completed form.Failure to do so nullifies the .JJ ra system warranty.E-man or fax completed form Company Name: A I)ioaA(L PI to the Uponor Fire Safety Design Department Contact ttt' DI CIAPAguet at Tgcnical.servicesluporAor.com or 952.997.1731. Phone: SC 3-i c bu°I o For questions,contact Uponor Technical Services at 888.594.7726 or technical.servicessuponor.com. Q- Fax: ,' Color of test orifice used: SS ,,//�� Job Name: 4i) T Terrace. Static pressure(not flowing)reading at incoming Project Number: L•it l water supply into home or at main shutoff: �tS Job Address: ,3g3t. Resi ual pressure(naming)reading at incoming water City: Ti,anoi supply into home or at main shutoff: Sy State,ZIP: ©(1- q‘)44.5 What time of day was the flow test taken? 4°B0 For designs not provided by Uponor,complete the following information. Flow test method used? Bucket U Flow Meter Designer's Name: )1Ga�..A46. Flow test gpm: ?C °'`„ Company i i r,tMi- How many gallons of water did the design predict q 55°Sas required? /7 Phone: /S - 9)' ���� Did the test meet or exceed design flow? tfYes U No Fax: Which sprinkler did you flow?Number: 1/. Is the warning sign permanently attached close to the Location of head: cD� A+Tti 04.4 main shutoff valve? U Yes C'9 No Date left in service with all valves open: 7 24.11 Was this system required by code?rites U No E ' Test Witnessed and Verified by: Name Signatu�rg Occu ion Date 01;14e, ll yZ4 BJPr- 7' 2r'— 0 0 Additional Explanations and Notes d Uponor,Inc. Tel:600.321.4739 5925 148h Street West Fax;952.997.1731 Apple Notley MN 55124 USA Web:www.uponorisa.com