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Report (63) ! , — ,. t , , , 13 5 , , ,., , , .., ,....., . UpOf101 FIRE SAFETY SYSTEMS R AQUASAFET" FLOW TEST VERIFICATION /'Fist Pot? --05084/ ,,, FORM AaSETM Flow Test Verification Form Alliance Important:Installing contractor Hast submit this Member ID: completed form.Failure to do so nullifies the Company Name: A11;6441. PitAIM41 N warranty.E-mail or fax completed form ,1 to the Uponor Fire Safety Design Department Contact ?ekff- Dtsle+wta,n at tadskaLandcatitypotpx&om or 952.997.1731. Phone: cos-111)-- 3y el D For questions,contact Uponor Technical Services at 888.594.7726 or technicl.serrviicesluponor.con1. Fax: 111'0Color of test orifice used: ,,/� Job Name: IwkVr 'Terrace. Static pressure(not flowing)reading at incoming, Project Number: `.4 1 (( water supply into home or at main shutoff: bo a Job Address: /3.5-9Z7 20-4,,-1t,.mi., � idual pressure(flowing)reading at incgming water City: Ti)µroa supply into home or at main shutoff: State,ZIP: ©IS) q}aa).3 What time of day was the flow test taken? 8e yo For designs not provided by Uponor,complete the following information. Flow test method used? �ucket U Flow Meter Designer's Name: / / ' Flow test gpm: ' 1' 73(.67) k-0-164,A__ Com Pa y n U: ei/b!` How many gallons of water did the design predict 9S -9q - 5 39 o as required? I `7 _ Phone: Did the test meet or exceed design flow? Cfr/ s C I No Fax: Which sprinkler did you flow?Number: if% S Is the warning sign permanently attached dose to the Location of head: c � 2 A+14 444 main shutoff valve? C]Yes Crgq Date left in service with all valves open: g-2.S-/7 Was this system required by code?arlYes CI No v g WitnessedTest and Verified by. f. Name Signatur Occup on Date 4. O R U Additional Explanations and Notes cr i Uponor,Inc. Tel:800321.4739 5925148th Street West Fax:952.997.1731 Apple Valley,MN 55124 USA Web:www.uponor-usa.com