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ill si?©17 - 0�?I fid.- , f 0 ponor . )2... - Gddiat). 4-- F #E SAFETY SYSTEMS AQU, SAFE"' FLOW TEST le__4:) - VERIFICATION ' d 'b Aq- aSA ' Flow Test Verifieatio 0 Form ••f..a. .s.rw<ey.• .•e...•. wwaa•.. .....a..r .arev�:rta +xa..•x.. .we•rw. w..vr a... ♦rx at..r s:.; .••♦t•w, wxw w.r.�.a Affiance. .a.•'. mailsubmitthis Member ID: completedform. to do so the C� ,a: ft!1«�f lu,S ,ins "r to the throw Fire Design « nt Contactdoe- 1).5L .i o a •; &, or ►2,987.1731. , services at. F": Colorof test 23t'c. S Job Name: T 4 t c.,,./..,,e_ Steric pressure(not • ,3 , reading at incoming Project Neater let C voter SCI j+tom tiorCte.r at main shutoff. 3 e Job Address: 14 14 " ..- Residual p�utre(flowl 'M reading at interning water 9 sly into or at .�,' sFnrtcff< (,,b-� State,ZIP: C)(2-- 72•- 3 c,rff ,7 the slat time of day , 'flow test taken? 1 P44 For deskos not prodded by Uponor,completefrollovitiej n, Row test method used? ' Bucket Q Flow Meter fj � Demo's Name: "1`,r!1/ t o j'j < Flow test 4Pro: i N1' How many gallons of r did the design predict as required? 1) Phone 2 9 7'✓ ,3L, Did the test meet or ., _, design flow?, 1Yes 0 Na Fax Which sprinkler did you . ?Numb , K burning n g pertnanardy attached close to the Location j+0 of heat , gnat ht w?.,�.I f i rr1 r? main of valve? C}Yes i8"No Date left in service with I;valves open. if-L'1) Was this system regraked by code?,trfes ©No a Test ilifitnessed and Verified by: o Nance Elcttr Date j koi 1#- 'c u// °I ,-e" 11-1.-/ Additional and Notes > Uponar Inc. Tel:8111321.4739 i .1 Apple VolleyVaffey,MN SS124 USA W