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4, tiAS�A ETM FLOW TEST
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Airlan°eMember ID: 1964 c�asit� tau de"so a
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totbai$PonorFhesairDilsign Dea"rtmO
Contact Jon Hinklerit a' $401
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503-49°-°763coat tootle!,'T'
Fax 971-250,3808 Cour of test orifice used: Black
lob N Summit Ridge static"press(not flowittla ing)reading •at incoming
Project Number 19070 F 002. Cpl r titch home or at train shutaff: 78Dsi
Job Address: % �i . .f ,- ► pct ire(f ng readingat inc n water
city;irloo,lf,
t r)1L.. supply into home or at main shutoff',
State,ZIP: 41/ -t
What time of day was the flow test taken?
For designs not provided by tlponor=complete the Flow test method used? I::t Bucket i Flow Meter
folioarmg information i 1
Dors Name: Patrick Brown Flow test gprn:.
tlponor How many gallons of water did the design prat
Company: as required?17aOrri '
Phone: 87726 Dktthe test meet or exceed design flown 0 Yes O No
-:-,;— _-Fax: z' :7 731 -_.. "' ` " sptin i# dici; flew?Nutrtber:
Is the warning sign permanently attacheddose to the union of heaai:
n shutoff valve? ` Q Yes U No
Date left In service with all valves open. '^ . 1 /
Was this:system required by code?E1 Yes la No
Test Witnessed and veil/tad by:
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IAdditional Explanations and Notes
.ln<. Tel 800321.4 9
925 148thStreetWest .9971731
Apple Naligr MN 55124 USA Webs wwelailaletemelllAlet