
On you provide may be used for secondary purposes Privacy Law, s.1504 (1)(m) . OWNER INFORMATION Please print clearly in ballpoint pen. Additional information on back page. Owner Name Street Address City State Zip Code Owner's Contact Person Telephone Number ( ) FACILITY INFORMATION Facility Name Street Address City Zip Code County Assembly Location Manufacturer Size Serial Number Model Assembly Type DC DC Detector INITIAL TEST First check Closed tight Leaked Stat.
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How to fill out the Double Check/DC Detector Performance Test - Department Of ... - Dsps Wi online
Filling out the Double Check/DC Detector Performance Test form is a crucial step in ensuring the safety and compliance of your backflow preventer systems. This guide offers a clear and structured approach to completing the form correctly to meet regulatory requirements.
Follow the steps to successfully complete the form online.
- Press the ‘Get Form’ button to access the document and open it in your chosen document editor.
- Begin with the owner information section. Clearly print the owner's name, street address, city, state, zip code, and the name of the owner's contact person along with their telephone number. This information ensures that all communication regarding the test can be directed to the appropriate individual.
- Next, proceed to the facility information section. Enter the facility name, street address, city, zip code, and county. Also, include the assembly location, manufacturer, size, serial number, and model details.
- In the initial test section, mark whether the first and second checks were closed tight or leaked. Record the static pressure differential (PSID) for each check as required.
- Continue to the final test section, again noting if the checks were closed tight and recording the static PSID values.
- For the detector bypass assembly initial test, specify the results of the first and second checks, detailing if they were closed tight or leaked along with the respective PSID readings.
- In the final test section for the detector bypass assembly, document if the checks were closed tight and provide the static PSID readings.
- Proceed to the forward flow test section, stating the designed flow rate and the actual flow rate in gallons per minute (GPM).
- Complete the section regarding indicating control valves by mentioning the number of control valves that were open during testing, along with any tamper switch status or parts replaced.
- Finally, certify the test results by filling in the tester's name, registration number, time of day, signature, phone number, and the date to confirm the test was conducted personally.
- Review the completed form for accuracy. Once all sections are filled out, save your changes. You may then download, print, or share the document as needed.
Ready to ensure compliance? Complete your document online today!
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What does Wisconsin Department of Safety and Professional Services do?
The Department of Safety and Professional Services (DSPS) is responsible for ensuring the safe and competent practice of licensed professionals in Wisconsin. The department also administers and enforces laws to assure safe and sanitary conditions in public and private buildings.
Who oversees the Wisconsin DSPS?
Sarah Norberg / DPCP Division Administrator In her role, Sarah oversees approximately 50 employees who process initial and renewal applications for health, business and trades professionals, provide legal services to the division and call center services for the agency.
How do I contact the Wisconsin Department of Safety and Professional Services?
A: Contact the Department of Safety and Professional Services at (608) 266-2112 or dsps@wisconsin.gov.
How do I file a complaint against the DSPS in Wisconsin?
File A Complaint Methods. Online Complaint Form. File your Complaint here. ... Process. The Division of Legal Services and Compliance (DLSC) provides compliance services for the agency's boards and direct-licensed professions. ... Alternatives. DISCUSS COMPLAINT WITH THE CREDENTIAL HOLDER OR HIS/HER SUPERVISOR.
What does Secretary of State do in Wisconsin?
Wisconsin's Constitution requires the Secretary of State to maintain the official acts of the Legislature and Governor, and to keep the Great Seal of the State of Wisconsin and affix it to all official acts of the Governor.
How do I contact the DSPS in Wisconsin?
If you require assistance with any information or services found on the Department of Safety and Professional Services website, please contact us at (608) 266-2112 or dsps@wisconsin.gov.
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