Request For Testing Of Hydrants
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1Round Rock Fire Marshal's Office
203 Commerce Blvd
Phone: (512) 218-6632 Fax: (512) 218-5594
Round Rock, TX. 78664
Request for Testing of Hydrants
BUSINESS NAME: _________________________________________
DATE : _____________________________
ADDRESS : ______________________________________________
PHONE : ____________________________
CITY - ST - ZIP : ________________________________________________________________________________
ATTENTION : ____________________________________________
FAX : ______________________________
SIGNATURE: ___________________________________PROJ.ADDRESS:_______________________________________________
IMPORTANT
IMPORTANT
IMPORTANT
The Round Rock Fire Department is responsible for providing test information on the location indicated on this form.
There is a $100.00 fee for conducting this test. It is the requesting party's responsibility to ensure that the information is
appropriate to the location of your project. Information provided is an indication of the water supply characteristics in
the immediate area on the date and time noted. The City of Round Rock does not guarantee that this data will be
representative of the water supply characteristics at any time in the future. Please attach map indicating hydrant
locations.
Test Flow Hydrant Address:
Block #
Dir
Street Name
Type
Flow / Residual Hydrant Address:
Block #
Dir
Street Name
Type
Hydrant Location (if other than street address): __________________________________________________________________
*Please attach map indicating hydrant locations.
DO NOT WRITE BELOW THIS LINE
Flow Hydrants:
Size Nozzle:____________________________________________________________________________
Pitot Reading:___________________________________________________________________________
Discharge Coefficient:_______________________________ ______________________________________
GPM:_________________________________________________________________________________
Static:_______________________psi
Residual:_________________________psi
OFFICE OF THE FIRE MARSHAL - TESTING OF HYDRANTS
Fee: $100.00
Paid date:________
Check Number: ________ Receipt Number: :_________
By:______________________________
Date:______________
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