330 Sargo Rd RES23-0018 - backflow testCity of Atlantic Beach ( )02 Asgissi Lmw
Atlantic Beach, FL 32233
BACKI'LOW PREVENTER
TEST AND MAINTENANCE REPORT
Name of Premises:
Service: Address: 330 Sargo Rd
Atlantic Beach,
Account No:
Fl- 32233
Mailing Address: 6806 Dayton
.,�qn Rd i.a..cksonville
FL 3221,10
..............
Contact Person:
Phone No:
Type of
Type of Assembly: RPDA
Manufacturer: Febco
Model: 860Serial
............ .
............... .
No: H55277
Size: 3/4"
—
Location- by front door
- irrigation
Gauge Mfg: Mid -West
ID No: 06211302
Date Calibrated/Verified: 05-10-2023
A
Check Valve 42
Relief Valve PVB or SVB
......... .
X light w
Closed tight
at
X1111, Opened at 2.5
Air inlet opened at psi
8.4 PSI
2.1
psi
lbs reduced pressure
Did not open
Leaked
Ll Leaked
Did not open
Check valve held at PSI
leaked
U cleaned only
U cleaned only
cleaned only
cleaned only
Replaced:
Replaced:
Replaced:
Replaced:0
rubber kit
rubber ldt F
ribber kit
U
RV rubber int
CVasscmblyly
CV assembly 0
CV asscix*
RV assembly F]
disc, air inlet i.
or
disc Oj
or
disc
ED
Of
disc
disc, C
4 -rings Lj
O -rings
0
diaphra*s)
seat, CV LJ
sprin& air inlet U
Sent 0
04
Seat
0
%ext
Sprint, CV 0
spring 0
stettitgttide
spring
stem/guide
0
0
spring 0
imide Fj
reta finer 0
retainer cj
retainer
n
04inp n
gu0
C7 -rings 0
lock nuts C
lock nuts
Other
Other 0
Other
Other
- — -------
...... . . ........................ .
sed tight at
Clow tight
Closed tight at
a,
Air Wet
psi
P
Check valve nst
Remarks: Installed by others
I certify that the data in this report is accurate:
Tester name: Josh Clarkson
Tester Signature . .... ���. .. . ....... . ............ Datc: 07-31-23
Affiliation:
Cat'9
J06-23-14104 —
904-268-8009
Tester #2
rester Signature--..... ....... . . .
. . ..... --.- ........
Affiliation:
Cert #
-
Tester Company:
----
Adds'.
.. . . .. . ......
This assembly: Passed Failed