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THE JACK CONSTRUCTION MATERIALS PHONE 860-243-9714
E • 97 OLD P000ONOCK ROAD 1.800-423-0112
FARRELLY BLOOMFIELD,CONN.06002 FAX 860-286-0867
COMPANY 150 UNIVERSAL DRIVE(Rear) PHONE 203.777-5548
• NORTH HAVEN,CT 06473 FAX 203-777-3147
COLTON ROAD PHONE 860.739-5457
EAST LYME,CT 06333 FAX 860.739-8513
149 SOUTH WEST CUTOFF PHONE 508-752-PIPE
WORCESTER,MA 01604 FAX 508-797.4455
176 CHASE RIVER ROAD PHONE 203-759-1135
WATERBURY,CT 06704 FAX 203-759-7522
WATER/SEWER TEST REPORT
PROJECT/LOCATION: �3 N11, CACYW2Vt@ 'ZCA < �^-}`��%
INSPECTOR: QP t r%; rc.IO2 IG TESTED BY: W ll k�(ON'
DATE OF TEST: , � �C�tI CONTRACTOR: �,� Q'��"!' �C-� tyt, o ►►i t�
I HYDROSTATIC TEST
WATER MAIN TEST ❑ SEWER MAIN TEST U,-' LENGTH OF TEST:
STATIC PRESSURE: TEST PRESSURE:
ALLOWABLE LEAKAGE: ACTUAL LEAKAGE:
TEST RESULTS: PASSED ❑ FAILED ❑
REMARKS: rc s} �celte tG� y ho y 5 t 6\` 5�:7 tiZ- 3 S fey+
L\e t¢ r
AIR TEST
MANHOLE TEST PRESSURE TEST RESULTS
NUMBER IN P.S.I. TIME OF REMARKS
OR STATION START STOP DROP IN MIN. TEST
G1eGnCa1 }k0,isq- 3.Yi' 3 S •$UiZSS
I certify that the above information is a true and accurate account of the tests performed at this location. '
SIGNED:
1.1
INSPECTOR TESTER