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Report (35) J')' srccJ7 - voro1 I:10 ti 1 , 3 11f RE SAFETY SYSTEMS AQ • SAFE'*" FLOW TEST VERIFICATION • SFE Flow Test Ve fic do : Form Memfirwortintt ' ......masts this conerlated form. to daso rudders the Company Nie. J � �. '"' ,�tA�,�j l + �► � or fax�form 5 to tire trporearThrs • Desists Deplatorert Contact 12i* +" at or 952.9f17.1731. For Phone ` - aorb a T/2questions, ar t}- Upiesor Technical Services at Fax Color of test orifice 3r.5 lob Name: (7t .Se.x«""C _ static pressure knot marring at incomitrg project Number: water supply Into • or at(rain<shutoff: Job Address: fi ^� , a�c i , �GrE( t at Inco n water City: [ supply into home or at',' n shutoff: 0 Some,zip: t (Z. 9 722,3 What time of day was << flow test taken? g rtiAL Fel' net folio inform is n. by t#Donor.Mete the , method used � Q Flowr Meter Designer's Name: FlPw test gPs: nY *''' Now many gallons of did the design predict as required? 1 Phone: 9S2- 99 75-3-41.6Did the test meet or design flonv?Atil_ lyes Ca No Falc Which sprinkler did � (Ado Number:4 taw:: Is attached dose to.the of hoo dr p' V 4do t `,� main shutoffvalve? Cf Yes ! system required by code?1 13 No Date left In service all valves operr Was this 31 Test Wilnerssed and Verffied M Sig t re a ,<k Date - dilations!Explanations mid Notes - t4sonor,bic. Tel:8i21.4?39 59251 West Fax:952:997,1731 Apple Val,;MN 55124 USA Witte issramegicitionnrancen