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Correspondence - 4515 Shoreline Drive - 1/17/2023 Jan.09.2023 11:49 AM Interstate Testing 7637555365 #2784 F 2/ 5 Xn ,rate Tee ti*LL pa',k s. ' Bac�ow ' t b'ly �"est depo A=ksI INN'S5303 (OZ..DCVA,PVC,SPV%) 63)74+4149' • luterstaubet+sstlegoawstr�et City: . Prop Owner inf©rii tlon ` Presbyterian Homes Lake Minnetonka Shores 4515 Shoreline Dr. say.: ZIP Spring Park. . WN 55384 Pro�ie+�c':Co�t �' +aN:.' aaa�o: ptaaa COEXGerber Cor Gerber 651 648-5645 . :; Aches: •�r� . 451.5 Shoreline Dr,. Sprina Park MN 55384 • �. Stag 21p:. S r no Park MN 55384 t'ropieirt►owaat';�t!>hgai :lr plane: Presb Tian Homes Lake Minnetonka Shores . Co Gerber 651 648_W5 Type 22 OfAssembI work�Performed atPZ' :. .. ., ' DG1ri Teat X .R Teat R Ir Rg Taxt r RB est;...,,.,Rc{wlt-�.RB O&C"Ow Assembt lnfor>med.on im :.. : . . • ., Modem..:. . S :'. .. S , 1/2" Wilkins, 975XL 3027862 Wash Down Hose Lomdoa*fAmm*,- KNitchen rea Backf low Assembly'hest Results :R,•:. Che*Fx;"—i $but.wvaty*02 1��11+e� / Ct�c�c'Valto �3 as ... Ahraai .Yalva : . . dpm.,.....» 00se4...X _ opan,' crow.:.�.. 4p�oY..-, :..aril up" • .: '�rora+�ca•01t��i►�fd:. otd a�lt opea „�.�„_„ Cbw d . cpe� sows . �,, ..,. .• :Opel gnaed,....». . 1'raa++►e�Di(k 1..,�..'-,,,psld' D1Q tot open�.,,.� COIM'tt�tllb:. , . PASS;;,,; Tester's Information, CerriB�adan: : :' Dace: Donn Miller BF065323 01-06-23 Jan.09.2023 11:50 AM Interstate Testing 7637555365 #2784 P 3/ 5 lnire>�atat�Tea* Wg,.�:�.0 PA 19�t 5S. $ackflo V.Assembly es : . A=ismAN s5383 tom,DCVk PVC#,,SPVB,) E7g3)14+hb149 IpRersta�et icig�+COMCOst�.aet CIt . Piropeirf+y Owner fafonlbtg"O n •. Presb Brian Homes Lake Minnetonka Shores �� '� • '�. 450�1 Shoreline Dr. Spring Spring Park AN 5544 NOAWHPROptC CoEX Gerber 651 468-5645 Ad 5 S 451horeline Dr. S rin Park MN 55384 CJW ring Park MN 55384 Presb ran Homes Lake Minnetonka Shores Co Ge er 851 648-5645 Nance; :hone: Type,of Asseirinbl ;/"Woik Parformed Test X it R6 T R r R8 Year R' 1•at,.,M,.R r R11t u aCblow Assembty lnfomation 3/4" Wilkins 975XL 3520439 LCOU601 ofpnembir.Murt, Boller room BAc w Ass ml*Test su is '1'yp+a:of Slbuiit;QR Volvo 02. �►i IVatve� Gkteck VOYb.#Z Atembly 1a�stalve' RPZ o ,n "" apes CkWO—I-- Opued At': Uo--.pod open t —A, bid not OPOO 'Open ' C14ud 4pea...��.: Oaftd— fPMMM ty ._,._:�.pWd !VB� �+ot at'' ...;.,.:..Rad Cles+ad.-...... CQpIMltttfi. PASS ML Tester's Inforr»ak o,n Sflxrat+r Creircadon:�l: .. Qatei" Donn Miller BF065323 01-06.23 Jan.09.2023 11:50 AM Interstate Testing 7637555365 #2784 P 9/ 5 �keOUte'TeatWg,W. Assembly Test Report P10--fty-ss Back-flow A>aoik9610 5*O3 '(RPZ,DC VA,•Mo.$PVBj (763)#"1-49 cittiuterstatetesg�caaau�t.net ' Pto a /t waer Infor adon Presbyterian Homes Lake Minnetonka Shores r'RY,A�d :• : 4515 S oreline.Dr. CIRyt Smote¢ Zlp, Sprina Park, IdN 55384 •p �`:CA�te►at�gaQ�s'•: Aetna Pteone� CoryGerber, 2og Gerber 651 64MO46 •51�d5�Shoreline Qr. Spring Park MN 55384 S rin Park MN 5 384 P �:01A!t101'fiq'bdi�ie: : !V#m�k; �hoite:• jPre!!Werian Homes Lake Minnetonka Shores), Cor Gerber, 651 648-564 e of ASSembl :/Work Perfo.med .�CVA' .•. Test X .R R : 'Cate A r RO. Test Test,..,._ r R ...,,.' BackRow AsserB Y btfnrma#ion M14 Wilkins 975XL 3413596 Chute Rinse pt mw7 ras room, ower eve BackOowr.AsseMhly TOO'ResUlft .:... .pi uk Yt ve. : .' Sliast�l Vatva 3 :R ief Yst ►e ;Cliedc V .TpMt:V' e ripe 4. pM. 40v; Xe Open cbwd 0Pelw..,,.. Oand...,M.�: Pt+eWAV*Cali.►.- ---.»wad t►++rssure ntf pd� :• ..�. Cased�.;.,.".. Ope40d iC....:,,...p� ap" .GO .a Did woe open Olcl= rts4. Tester's information Tee 's.N�int:; etr 5lgi=ur�: C�r�`iR lei . ..• . 01-06-23 Jan.09.2023 11:51 AM Interstate Testing 7637555365 #2789 P 5/ 5 �wwr�rw+ Interl pute T"fing Uc bl'. Test.,Dt�port - AnOtta,MN 553103 (Rpztl DCVA►,PVB,OW) (763)741» 09 �taassn�t' City: Property/owner tnformadou P,resb Brian Homes Lake Minnetonka Shores 4.559 Shoreline Dr. Cttye sc,:cec rim. Spring Park, 55384 Rmw Pboa� Co Gerber. 651 46M645 4515 Shoreline Dr. Sprina Park MN 55384 city!: Stature $ rin Park MN . 55384 5584 Name. 1'hd:ras Presb e6an Homes Lake Minnetonka Shores Co a er 661 648-5645 Type of Assembl f or. -Performed tit. X Tes R Ir R13 Tw r. as BUMOW ASSe bl. . Information `:: 1" Wilkins I 975XL 13342316 Boiler Make Up Lgptloq of Aenebly: AL soiler room Bac�ow Assembly Tact Results 7e:of :. .plecicVae.#at'; Sbntia>S�tatrlre ,iUrat�letV�re : . Op"..— .01"d',.X— r)pep Chad. .X Ope wom RA ;pw Opea Ciow..:. L P+ ieiili(C 7.0 V Dfdaotapea .y °pQ1---�,• —�, open Clowdw, opm Mood . WR _psid PY:B/ Vl OPM (Saed— op 4 at.... ..:M.psld p". ' ptasfnire.W(I:�,.,�.,...piEid. pld a+Dt apei► CPmfien�s:. "Tester's luf 6rmation: To gnattt Dow... 01-06-23 Jan.09.2023 11:49 AM Interstate Testing 7637555365 #2784 P 1/ 5 P.O. Box 55 Anoka, MN 55303 Phone: (763) 744-6149 Interstate Testing, Fax: (763) 755-5365 LLC interstatetesting@comcast.net x To: City of Spring Park From: Interstate Testing, LLC Fax: (952) 471-9160 Pages: 5 Phone: Date 119/23 Re: cc: ❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle Comments: Four backflow reports c/o Presbyterian Homes (Lake Minnetonka Shores) This fax transmission is intended for the recipient only. If you have received this fax in error, please contact Interstate Testing, LLC at (763) 744-6149. Thank you.