Hydrant Flow Test Form
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1HYDRANT FLOW TEST FORM
Amador Water Agency
I. PROJECT INFORMATION (TO BE COMPLETED BY APPLICANT)
Name:
Phone: (
)
Company Address:
Project Address:
Nearest Cross Street/Distance (ft):
Occupancy (Use of Building):
Sprinklered (Y/N):
Square Footage:
Number of Stories:
$
Deposit Paid / Date:
Receipt #:
II. FLOW TEST DATA FLOW HYDRANT: (TO BE COMPLETED BY AWA)
HYDRANT LOCATION:
________________
HYDRANT #: _____ OUTLET DIAMETER: 4" __ 2-1/2" __
SIZE & MATERIAL OF WATER MAIN:
Static PSI:
Residual PSI:
Pitot (PSI):
Observed Flow (GPM)
Calculated Fire Flow @ 20 PSI:
Duration of Flow:
Date and Time:
TEST (RESIDUAL) HYDRANT:
ATLAS PAGE:
HYDRANT #:
SIZE & MATERIAL OF WATER MAIN:
Static PSI:
Residual PSI:
TEST (RESIDUAL) HYDRANT:
ATLAS PAGE:
HYDRANT #:
SIZE & MATERIAL OF WATER MAIN:
Static PSI:
Residual PSI:
III. PUBLIC FIRE HYDRANT FIRE FLOW REQUIREMENTS (TO BE COMPLETED BY AWA)
Signature of
Print Name of
AWA WITNESS
AWA WITNESS
Time:
(am / pm)
Date:
/
/
Title:
IV. TESTER / COMPANY INFORMATION
Flow Test Conducted by:
Ph: (
)
Company Name
Business License #:
Company Address:
Date:
/
/
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Parent category: Business