Laboratory Evaluation Report for: Laboratory Faucet Backflow Preventer

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American Society of Sanitary Engineering Seal (Certification) Program Laboratory Evaluation Report for: Laboratory Faucet Backflow Preventer Tested under ASSE Standard 1035 Revised: April, 2008 Laboratory File Number Manufacturer Model. Address Serial. Other Identification Markings Size General information and instructions for the testing engineer: Within the text there may be items which are only advisory to conditions which experience indicates could be troublesome. It is not for evaluation related to acceptance of the product. There may be other items for which the judgment of the test engineer will be involved. Should there be a question of compliance with that provision of the standard, a conference with the manufacturer should be arranged to enable a satisfactory solution of the question. Should disagreement persist and compliance remain in question by the test agency, the agency shall, if the product is in compliance with all other requirements of the standard, file a complete report on the questionable items together with the test report, for evaluation by the ASSE Seal Control Board. The Seal Control Board will then review and rule on the question of compliance with the intent of the standard item involved. Documentation of material compliance must be furnished by the manufacturer. He shall furnish to the testing agency, a bill of material which clearly identifies the material of each part included in the product construction. This identification must include any standards which relate thereto. Page 1 of 9 pages (2008)

Product Name Model Number Size(s) Date Submitted for Review Date Review Complete Were the test units production models Or prototypes? Section I 1.0 General 1.1 Application. Is the purpose of the device, as stated by the manufacturer, as stated in this section? If questionable, explain: 1.2.1 Description. Does the device conform to the product classified as Backflow Preventers for installation on laboratory faucet? If questionable, explain: 1.2.2 Working Pressure: What is the maximum working pressure as noted by the manufacturer? psi ( kpa) 1.2.3 Temperature Range. What is the temperature range as noted by the manufacturer? F to F ( C to C) 1.2.6 Flow Way Open Area. Were the flow way cross-sectional areas verified by the testing agency? Were the minimum cross-sectional dimensions of the airport or flow way greater than 3/32 inches (2.4 mm)? Page 2 of 9 pages (2008)

1.2.7 Atmospheric Vent. 1.2.8 Repairability. Is the device repairable? Are internal parts accessible for inspecting, repairing or replacing? Section II 2.0 Test Specimens 2.1 How many devices of each size and model were submitted by the manufacturer to the testing agency? 2.2 How many units were utilized during the laboratory evaluation? Section III 2.3 Drawings. Were assembly drawings and other technical data provided? Were these reviewed by the testing agency? 3.0 Performance Requirements and Compliance Testing 3.1 Hydrostatic Testing of Complete Device What was the supply pressure used for this test? psi ( kpa) 3.2 Deterioration at Extremes of Manufacturer's Rated Temperature and Pressure Range What was the supply pressure used for this test? psi ( kpa) What was the temperature of the hot water used for this test? F ( C) What was the flow rate? GPM ( L/m) Test period was for hours/day for days. Page 3 of 9 pages (2008)

Was cold water between 33.0 F and 40.0 F (0.6 C and 4.4 C) run through the device at the manufacturer s maximum rated pressure for one (1) hour following the 80 hour test? Were there any observable changes in the physical characteristics of the device in which would prevent full compliance with the remaining tests of this standard? 3.3 Back Pressure of Downstream Check Was the inlet check held open and the air vent sealed closed? What was the initial height of water in the sight glass? inches ( mm) What was the backpressure used for this test? psi ( kpa) Were there any leaks in the downstream check as indicated by a rise in the water level of the sight glass? If questionable, explain: 3.4 Tightness of Checks On testing the upstream check, what was the initial height of water in the sight glass column? inches ( mm) Was the pressure on the downstream side atmospheric? The test period was for minutes. What was the final sight glass reading? inches ( mm) On testing the downstream check, what was the initial height of water in the sight glass column? inches ( mm) Was the pressure on the downstream side atmospheric? What was the final sight glass reading? inches ( mm) If questionable, explain: Page 4 of 9 pages (2008)

3.5 Atmospheric Vent Valve Leakage At 10.0 psi (68.9 kpa), was there any leakage from the vent port when the inlet valve was opened either slowly or rapidly? At the manufacturer s maximum rated pressure was there any leakage from the vent port when the inlet valve was opened either slowly or rapidly? In Compliance? 3.6 Backflow Through the Inlet Check Was the outlet check valve held open and the vent and drain outlet sealed closed? What was the pressure applied to the outlet of the device? inches of water column ( mm) Was there any leakage through the inlet check? At a pressure of 4 psi (27.6 kpa) applied to the outlet of the device was there any leakage through the inlet check? 3.7 Backflow Through Outlet Check Was the inlet check valve held open and the vent and drain outlet sealed closed? When a pressure of 6.0 inches (152.4 mm) water column was applied to the outlet of the device, was there any leakage through the outlet check? At a pressure of 4.0 psi (27.6 kpa) applied to the outlet of the device, was there any leakage through the outlet check? Page 5 of 9 pages (2008)

3.8 Back Siphonage Was the inlet check valve fouled with a 0.032 inch (0.8 mm) fouling wire and the outlet check valve held open? Were vacuums applied to the device per a and b respectively? The test period for each vacuum test was minutes. Was there a rise in the sight glass for any of these vacuum tests? If questionable, explain: 3.9 Back Siphonage Back Pressure T When the inlet check valve was fouled and a 4.0 psi (27.6 kpa) back pressure applied, were vacuums applied to the device per a and b respectively? When the outlet check valve was fouled and a 4.0 psi (27.6 kpa) backpressure applied, were vacuums applied to the device per a and b respectively? Was there indication of flow of colored water into the inlet piping during either test? If questionable, explain: 3.10 Flow and Pressure Loss What was the supply pressure used for this test? psi ( kpa) At a flow rate of 4.0 GPM (15.0 L/min) what was the pressure loss across the device? psi ( kpa) Page 6 of 9 pages (2008)

If questionable, explain: Section IV 4.0 Detailed Requirements 4.1.1 Allowable Materials. 4.1.2.1 Contaminated Materials. 4.1.2.2 Compliance and Certification. 4.1.3 Corrosion Resistance of Interior Parts. 4.1.4 Springs. 4.1.5 Diaphragms. Page 7 of 9 pages (2008)

4.1.6 Metal to Metal. Indicate material metal seat and valve disc. 4.1.7.1 Taper Pipe Threads. 4.1.7.2 Dryseal. 4.2.1 Identify the markings found on the test unit: a) b) c) d) e) Would these markings be visible in the installed position? 4.2.1.2 Describe how these markings were applied to the device: 4.3.1 Were instructions for installation submitted with the device? Were maintenance and repair instructions furnished by the manufacturer? Was the device in full compliance with all sections of this standard? Page 8 of 9 pages (2008)

TESTING AGENCY ADDRESS PHONE: FAX: TEST ENGINEER(S) We certify that the evaluations are based on our best judgments and that the test data recorded is an accurate record of the performance of the device on test. Signature of the official of the agency: Title of the official: Date: Signature and seal of the Registered Professional Engineer supervising the laboratory evaluation: Signature Seal Page 9 of 9 pages (2008)