Report (59) /YISTP•oo'7 — do '2av
, .'' L.- ti,./%2t r)011-01*P
orRE SAFETY SYSTEMS
,- ...,,,,11/4,Hrs,,,,,., ,, ) t-2 ,
AQ 'ASAFETM FLOW TEST
- VERIFICAT[ON
. .ua FE ru
Flow Test Verifieatio Form
= i ' ... ibis
►moi completed foot. todosmdnflas the
ef. ?f,. or fen conerberd feria
�a aar+y Name: , , (,�
to the UponorFlow .. Deelp DePortmient
Contact s1n 4v►. . at . ,, E a • . • or .99/.17331.
-�r€ -3 ygrFor 'a "m,, , tapir at
Fos: Color of test �c. ..."�'
Job lox "C- .e-.e� tic preswre(not . `,• ding at i►ecoming
�� UC water$4)1:1131Yi ;oratmain
Residual pressure(fi readingat ircorriklg water
C it C. supply into ,.r or at -in shutoff: , s t)
r
7
State,„ZPP: C)2 5'-,22.. '
AI
What time of day wasflow taken? /
For tiesigss not csrovIded by Uporsor,complete the
f awing h ffforniatiari. Filar fast method -. la8rrdcet Q i 24teter
ms's Name: 74r.cA"T. k+t....t.+e,,+,
Flo* 7 t•
parry (< c?fl r3 How marry gallons of ' r did the design predict
as rittiiiired? 0
i ` 7 r- } Did the test meet or .--.design f ow?„ Yes 0 No
1 /tit
F which sprinkler did • 'flow?Number if, /1,
Is tfle swerifitg sigrs penrsanert1y armed close to the i rr of hem .r°-
f#' rstitirtshutoff sem? Q Yes lis
Date left in service . all valves open: /P 4. -/)
Was th s system rem. red by code?Ji Yes Q No
..T+eStWedandV by;,
1 Name —4,551#t... .....
♦.a c.,,. Date
it
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tom,.eC. 'lel.800321.4739
525148th StreetWest Fax 952 997.1731
Valley,MN 55124 USA ilii cael