10-25-2022-03-08-40-PM-USCG-SITKA-611-Airport-Road-Back-Flow.pdf
PDF 327 KB Posted
- Solicitation number
- 70Z04524QKODI0019
About this file
This combined synopsis and solicitation requests quotes for annual backflow prevention system inspection services at the US Coast Guard Air Station in Sitka, Alaska. The solicitation seeks inspection of backflow prevention systems in accordance with the statement of work by February 15, 2024. Quotes are due by January 17, 2024 and shall be submitted to the contracting specialist via email. This requirement is set aside 100% for small businesses defined as specialty trade contractors with average annual revenue less than $19 million. The place of performance is the US Coast Guard Air Station located at 611 Airport Road in Sitka.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Back Flow Form
Anchorage Water & Wastewater Utility Attn: Field Services 3000 Arctic Blvd. Anchorage, AK 99503-3813 Phone: (907) 564-2762
FAX: (907)786-5001
EMAIL: awwufieldservices@awwu.blz
Service Type
Existing New Replacement
Replaces SN# Serial Number MOA # 1000520201 Assembly ID Contact Name Test Due Date 10/25/2022
Assembly Location Information Facility Name Location ID
USCG SITKA
Service Address Zip Phone 611 Airport Road 99835 (907)942-7562
Property Information Mailing Name Same Address 1
City ST Zip Telephone
Assembly Information Type Size Mfr Model DC 8” Ames 2000SE
Equip Location Pump room
Hazard Type Sprinkler
Water Turn Off Authorization: (Print) Time
02:36:05 PM
Is the Assembly installed in accordance with manufacturers recommendations and/or local codes? Yes No
Test Date 10/25/2022 https://mydoforms.appspot.com/
Initial Test
Pass Fail
Reduced Pressure Principal Assembly Check Valve #1 Check Valve #2 Relief Valve
Held at 0 PSID Held at 0 PSID Opened at PSID
Closed Tight Leaked
Closed Tight Leaked
Did Not Open
Pressure Vacuum Breaker Air Inlet Check Valve
Opened at PSID Held at PSID Did Not Open Leaked
Repairs and Materials Used Replaced check valve 1 and 2
Final Test
Pass
Reduced Pressure Principal Assembly Check Valve #1 Check Valve #2 Relief Valve
Held at 4.8 PSID Held at 4.6 PSID Opened at PSID
Closed Tight Closed Tight
Pressure Vacuum Breaker Air Inlet Check Valve
Opened at PSID Held at PSID
Test Gauge Used:
Manufacturer/Model: SN: Calib/Accur Date:
Midwest 07143561
Remarks Passed
Photos
Image 1 Image 2
Image 3 Image 4
Image 5 Image 6
Image 7 Image 8
Image 9 Image 10
Service Restored Yes No
The above is certified to be true at the time of testing Tester Name Company Name Steve Sizemore IV North Star Fire Protection, LLC Company Address Phone Number 520 W. 58th Ave. Unit G Anchorage, AK 99518 (907)677-1233 Tester Signature Certified Tester #
BAT 723
Customer Email
Other Email
Powered by www.doForms.com https://mydoforms.appspot.com/imageViewer?blobKey=ag9zfm15ZG9mb3Jtcy1ocmRyFwsSCmJsb2Jfc3RvcmUYgICM8Oqo_woM&blobName=9a856g853r3oft0$$05042020162136$$Published$$457$$P1$$P1.jpg https://mydoforms.appspot.com/imageViewer?blobKey=ag9zfm15ZG9mb3Jtcy1ocmRyFwsSCmJsb2Jfc3RvcmUYgICMoMLxlAsM&blobName=9a856g853r3oft0$$05042020162136$$Published$$457$$S1$$S1.jpg https://www.doForms.com
File details come from the government source that posted it. Updated .