American Society of Sanitary Engineering PRODUCT (SEAL) LISTING PROGRAM

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American Society of Sanitary Engineering PRODUCT (SEAL) LISTING PROGRAM ASSE STANDARD #1064-2006 (R2011) - REVISED: 2011 Backflow Prevention Assembly Field Test Kits MANUFACTURER: CONTACT PERSON: E-MAIL: ADDRESS: LABORATORY FILE NUMBER: MODEL # TESTED: MODEL SIZE: ADDITIONAL MODELS REPORT APPLIES TO: ADDITIONAL MODEL INFORMATION (i.e. orientation, series, end connections, shut-off valves): DATE MODELS RECEIVED BY LABORATORY: DATE TESTING BEGAN: DATE TESTING WAS COMPLETED: IF MODELS WERE DAMAGED DURING SHIPMENT, DESCRIBE DAMAGES: PROTOTYPE OR PRODUCTION: WERE ALL TESTS PERFORMED AT THE SELECTED LABORATORY? If offsite, identify location and tests involved: General information and instructions for the testing engineer: The results within this report apply only to the models listed above. There may be 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 Board. The Seal Board will then review and rule on the question of compliance with the intent of the standard then involved. Documentation of material compliance must be furnished by the manufacturer. The manufacturer 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. LABORATORY EVALUATION REPORT ASSE STANDARD 1064-2006 (R2011) PAGE 1

SECTION I 1.0 General 1.1 Application Does this application apply to portable field testing kits for backflow prevention assemblies (BFTK)? 1.2 Scope Are these analog dial type and/or digital instrumentation type BFTK? 1.2.1 Description Are these kits portable? Do these kits, as a minimum, include all necessary gauges, hoses, valves and fittings as required for field testing purposes? 1.2.2 BFTK Accuracy Requirements 1.2.2.1 Differential Pressure Gauge Accuracy Requirements Do the differential pressure gauges comply with the accuracy called for in this section? 1.2.2.2 Line Pressure Gauge Accuracy Requirements Do the pressure gauges for indicating line pressure on a BFP comply with the ASME 40.100 accuracy, grade C or better? 1.2.3 Pressure Range Do the BFTK s comply with the full scale pressure reading and the line pressure reading of the maximum range noted in this section? 1.2.4 Temperature Range State the water temperature range of the BFTK: F ( C) to F ( C) 1.2.5 Gauge Resolution 1.2.5.1 Differential Pressure Test Kit Is the test kit able to resolve 0.1 psi (0.7 kpa) or finer accuracy? 1.2.5.2 Line Pressure Gauges Are the pressure gauges able to resolve 5.0 psi (34.5 kpa)? 1.2.6 Working Pressure State the test kit s minimum working pressure rating as noted by the manufacturer: psi ( kpa) Is the BFTK in compliance (i.e., a minimum working pressure rating of 200.0 psi (1,379.0 kpa))? SECTION II 2.0 Test Specimens 2.1 How many BFTK s of each model were submitted? 2.2 How many BFTK s of each model were utilized for testing? LABORATORY EVALUATION REPORT ASSE STANDARD 1064-2006 (R2011) PAGE 2

2.3 Was product literature and other data submitted for the BFTK s? Were these items reviewed and utilized for the tests? 2.4 Did one device fail? NOTE: Failure of one BFTK shall result in a rejection of that model. SECTION III 3.0 Performance Requirements And Compliance Testing Was the BFTK tested as a complete assembly? NOTE: BFTK s shall be tested as a complete assembly. 3.1 Conditioning Test Was the BFTK exposed to 150.0 F +0 /-5.0 F (65.5 C +0 C/-2.8 C) and 33.0 F -0 F/+5.0 F (0.6 C +2.8 C/-0 C) for thirty minutes at each temperature prior to testing? 3.2 Accuracy Test 3.2.4 Procedure With the inlet connection to the high side of the BFTK at various pressures and the outlet connection of the low side of the BFTK at atmospheric, record BFTK reading: (3) At 14.0 psi (96.5 kpa): psi ( kpa) (4) At 7.0 psi (48.3 kpa): psi ( kpa) (5) At 5.0 psi (34.5 kpa): psi ( kpa) (6) At 2.0 psi (13.8 kpa): psi ( kpa) (7) At 1.0 psi (6.9 kpa): psi ( kpa) At 0.0 psi (0.0 kpa), does the BFTK indicate a pressure reading? 3.2.5 Did any of the recorded readings fall outside the accuracy tolerances specified in Table l? Was the BFTK in full compliance with Section 3.2.1 thru 3.2.5? 3.2.6 Additional Accuracy Test for Digital BFTK that use two pressure transducers to indicate pressure differential. 3.2.6.4 Procedure With both the high and low sides of the BFTK at a nominal working pressure of 200.0 psi ± 5.0 psi (13790 kpa ±34.5 kpa), record the BFTK reading: (5) At 14.0 psi (96.5 kpa): psi ( kpa) (6) At 7.0 psi (48.3 kpa): psi ( kpa) (7) At 5.0 psi (34.5 kpa): psi ( kpa) (8) At 2.0 psi (13.8 kpa): psi ( kpa) (9) At 1.0 psi (6.9 kpa): psi ( kpa) (10) At 0.0 psi (0.0 kpa): psi ( kpa) 3.2.6.5 Did any of the recorded readings fall outside the accuracy tolerances specified in Table l? Was the BFTK in full compliance with sections 3.2.6.1 thru 3.2.6.5? LABORATORY EVALUATION REPORT ASSE STANDARD 1064-2006 (R2011) PAGE 3

3.3 Hydrostatic Shell Test Which option of testing was utilized? What was the pressure that was applied to the inlet hose(s)? psi ( kpa) The test period was for minutes Were there any leaks or indication of damage to the device or any of the components? Was the BFTK in compliance with Section 3.3? 3.4 Pressure Shock Test 3.4.2.1 High Side Pressure Shock Test What was the pressure applied to the high side of the BFTK? What was the pressure in the accumulator? What were the number of cycles used? cycles During the cycling period, did the pressure rise rate remain between 3000 and 4000 psi/sec (20,685.0 and 27, 580.0 kpa/sec)? 3.4.2.2 Low Side Pressure Shock Test What was the pressure applied to the low side of the BFTK? What was the pressure in the accumulator? What were the number of cycles used? cycles During the cycling period, did the pressure rise rate remain between 3000 and 4000 psi/sec (20,685.0 and 27, 580.0 kpa/sec)? Was the BFTK in compliance with both the high side and low side pressure shock tests? 3.4.2.3 Repeat the Accuracy Test of Section 3.2. Was the BFTK in compliance with Section 3.2 following the pressure shock tests of Section 3.4? Did the pressure differential gauges maintain the accuracy shown in Section 1.2.2.1 after the pressure shock tests? SECTION IV 4.0 Detailed Requirements 4.1 Materials 4.1.1 Toxic Material Did any solders or fluxes in contact with the potable water supply exceed 0.2% Lead content? LABORATORY EVALUATION REPORT ASSE STANDARD 1064-2006 (R2011) PAGE 4

4.1.2 Wetted Test Kit Materials List materials of construction and the conforming standard: Bronze: Stainless Steel: n-cast bronze: Other: 4.1.3 Corrosion Resistance Are bodies, external parts and fasteners constructed of materials having a corrosion resistance at least to non-ferrous alloys? 4.2 Markings 4.2.1 Markings of Backflow Field Test Kits List the markings shown on the kits: (a) Manufacturer s name or trade mark: (b) Model number: (c) Serial number: (d) Critical level markings: (e) High and low connections identifications: (f) Maximum rated working pressure: (g) Maximum rated working water temperature: : (h) Usage orientation: psi ( kpa) F ( C) In compliance? 4.2.2 Method Of Markings How were the markings made? Etched Cast Molded Stamped Engraved Corrosion resistant plate securely attached Printed on the dial plate Other: In compliance? 4.3 Field Testing Did the manufacturer furnish testing instructions conforming to ASSE/ANSI Series 5000? 4.4 Manufacturer s Instructions Were complete operating instructions, including information on periodic calibration, packaged with the BFTK? LABORATORY EVALUATION REPORT ASSE STANDARD 1064-2006 (R2011) PAGE 5

TESTING AGENCY: ADDRESS: PHONE: FAX: TEST ENGINEERS: We certify that the evaluations are based on our best judgement 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: COMMENTS: PE SEAL *To insert images into document (PE seal and signatures) Adobe Acrobat Pro users: At the top of the page, go to: Tools > Advanced Editing > TouchUp Object Tool. Once you have selected TouchUp Object Tool, right click within the document and select Place Image. Choose the image you want to place (PE seal or signature) and then select Open. Once the image is in the document, move and re-size the image accordingly. Save and send to ASSE. Adobe Reader users: Adobe Reader does not allow users to place images into the document. You must print this completed document and then sign and stamp the PE seal by hand. You may then send the completed document to ASSE via fax or mail, or you can scan the completed document and send via e-mail. LABORATORY EVALUATION REPORT ASSE STANDARD 1064-2006 (R2011) PAGE 6