Report ' I
} uponol
j
,;,,,,,_,... , i
, , :
4 g T r-
.4.':' - „1.,,,,,„::,; . FIRE SAFETY SYSTEMS
�` AQUASAFET'w FLOW TEST
} 7 _��� VERIFICATION
•
AquaSAFE ` Flow Test Verification Form
Alliance this the
Member D fens
�fa .n to do so�
Company Name: system
t.�4+�tvtL E- orfax i
to the Uponor Hre S qt Design 9
contact: 'S"r . 4 I itle at or 952. 7.1731.
Phone: �ts3-`��Q —�� Few exp uponor Ted m Seu*es at
r tesheisaissyksifiaulaus-
Fax 91 t-25 " 'S q Color of test orifice used:
Job Name: 51.."...„4,..-1F � t37 Static pressure(not flowing)reading at inconu'ng s
Project Number: I a bit) ('�o S water supply into home or at main shutoff: "� °,
Job dress: 13�-1-4 Z 5'� tV".°4)--\V".°4)--\--AResidual pressure(flowing)reading at incoming water
City: i t c r. supply into home or at main shutoff:
State MR .,8t._ 22.11
What time of day was the flow test taken?
For designs not provided ty Uportor,complete the Row test method used? LI Bucket f Fioew Meter
fnn►ing 117fo1f/lation, pw"
Designer's Name: Flow test i
How many gallons of water did the design predict
Company fy"
as required? �,
Phone: Did the test meet or exceetYclesign flow? byes Ct No
r
Fax Which sprinkles'did you fliow{?Num
is the warning sign permanently attached close to the location of head: G. v'
° ,aVOt l
main shutoff valve? U Yes Ci Nobate left in service with all valves open: '
Was this system required by code?CI Yes CI No
Test Witnessed and Verified
Nam' -kk"Ov. .t,.. .c.,. �"`�`ture - • I - rs— t 1
1
Addftionel ations and Notes
i
.Inc. let:800.327 A739
€ 5gS 14�Street West Fax:952.-997.1731
i Apple Valley,MN 55124 USA Vida
)