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Report (32) .�` inn ST 017 — O b 0 7S- 12. Z It s UPOAOI - b, FIRE SAFETY SYSTEMS ' , AQUASAFETIA FLOW TEST i VERIFICATION FORM : ASTM Flow Test Verification Form Affiance Important Installing contractor must submit this Member ID: completed form.Failure to do so nullifies the Company Name: A I I.towtcz P(t�„iei Nsystem Y E-mail or fax completed form 5 to the Uponor Rre safety Design Department Contact teitr+' Dt s inMa,n at technical.senvises@uponorcomt or 952.997.1731. Phone: So S-it c1 1- 34°I0 For questions,contact Uponor Technical Services at 896.594.7726 or technicalservicesteuponor corn. Fax: ,,//�� Color of test orifice used: 6'55 Job Name: FuVet Terra,f Static pressure(not flowing)reading at incoming 1 Project Number: . i water supply into home or at main shutoff: Job Address: 1.353'2 mac,.... VL...�""NCc" Residual pressure(flowing)reading at incoming water City: TI)w%I supply into home or at main shutoff: S-1..., State,ZIP: ©F-i q%)445 What time of day was the flow test taken? 13'O° For designs not provided by Uponor,complete the . following information. IFlow test method used? a Bucket U Flow Meter Designer's Name: i'_ Flow test gpm: 9451 Company: cull✓ How many gallons of water did the design predict S - ,- 5}�o as required? 1 7 ! Phone: Did the test meet or exceed design flow? ..// s 0 No Fax: Which sprinkler did you flow?Number: ii. / Is the warning sign permanently attached close to the Location of head: Del.2._ A4:1-ti 444 main shutoff valve? ❑Yes allo Date left in service with ail valves open: 'Zs'. c--- Was this system required by code?fW'es J No N gTest Witnessed and Verified by. s Name Signatur OccupOccupzion Date if O R U Additional Explanations and Notes a i/ Uponor,Inc Tei:800.321.4739 5925 148th Street West Fax 952.997.1731 Apple Valley MN 55124 USA Web:www.uponor•usa.com