Report (24) uponor
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__ F_Iii_E SAFETY SYSTEMS
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- - '-' V--:5 AQUASAFErm FLOW TEST
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VERIFICATION
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1A.q'..','.'lle'mbi.;ei.ar :ke., 17..c2 Flow.
(-Test_3Icknoaletedot:foInstalling n.,Verificationac or e.,r lot:orn in uus to i fs re bs the
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Company Name'.
Contact: at e u
Phone 859476 Or o *
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Fax:
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---,-- — Color of test orifice used:
Job Name: AZ .0'
- - Static pressure(not flowin )read at incomin
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Project Number: jfit3 water supply into home or at main shutoff
Job Address: 7 LI 7 c ieit-., ----;,„ -----------------.-----____
.- „ o• ' Residual pressure(flowing)reading at incoming water
City: • --45-41 '4' -----__ supply into home or at main shutoff.
State,ZIP: '
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What time of day was the flow test taken?:
For designs not provided by Liponor,complete the
following information.
Flow test method used. 41/Bucket j Flow Meter
Flow test gpm:___1_,______ __,....
Designer's Name.
How many gallons of water did the design predict
Company: ^.. • _
as required?
Phone: Did the test meet or exceed design flow? eYs j No
Fa :
x ------------------- Which sprinkler did ou flow?
44 Til Is the warning sign permanently attached close to the Location of head:
4 6.1 .....),main shutoff valve? J YesearNo
Date left in service with all valves open:
Was this system required by code?ilKes j No
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Test Witnessed and Verified by:
Signature
Occuo.. on I) to
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Additional Erplanations and Notes
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Uponor,Inc Tel.8C0.321.4739
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5925 148th Street West Fax 952.997.1731
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Apple Valley MN 55124 USA Web:www.uponor-usa.cono
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