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Home My WebLink AboutLA178544 . � � �� 7�� , � ,� �� s . , . . Manufactured Home Svstems Test Affidavit This form must be completed in its entirety and be submitted at the Building Final inspection for the installation of a manufactured home. All tests must be completed and signed off on this form. A certi�cate of occupancy will not be issued until this completed form is received. SYSTEMS TEST VERIFICATION Description Date Passed Signature of Tester Drain Line: Purs�ant to cFR s2so.s�2�b� Date: s'�y,,�� /� Print Name of Tester and Company: ,�� , ` " �t� W8t@�LI11@: Pursuant to CFR 3280.612(a) Date: �-f . Y, �� /� - Print Name of Tester and Company: Fixture Test: Pursuant to CFR 3280.612(c) Date: � • (�� ' �� Print Name of Tester and Company: ,,.�, Gas Test: Pursuant to CFR 3280.705 and IFGC 406.4 Date: '��__(�.. a � *,,,, Print Name of Tester and Company. � .� � 6�- j � ��v,•� � iN1 u.�k r. i!�'t�� t-�� .Sr:.a:� Electrical Operational: Pursuant to cFR s2ss.�o2 Date: ��I� �� i%�"�� Print Name of Tester and Company: ��; ,/� ��d'?'S" �y��✓�Uj�'� t�-��'��r,L Electrical Polarity: Pursuant to cFR 32ss.�o2 Date: s-G/�-�il n Print Name of Tester and Company: ��,C��v� ��t,�r �� '�r,� EIeCt1'IC81 C011t111Ui�y: Pursuant to CFR 3285.702 oate:�G/��;� Print Name of Tester and Com an : ,, r'" �� P Y ��'�✓'� �G��Q S �G'/'�fi�f� ��;��'/"rG Smoke Alarm Test: Pursuant to cFR 32so2os Date: ��y_Z� � Print Name of Test e r a n d C o m p a n y: -'`�/ I cerkify the above systems testing has been completed and was found to be in compliance with the provisions identified for each systems test: r /� �J Si nature: �� r �' �� Date: �7 "�v � § 3285.604 Plumbing Tests and inspection. (a)Water system. All water piping in the water distribution system shall be tested by subjecting the system to air or water at 100 psi for 15 minutes without loss of pressure. (water heater disconnected) (b) Drainage and vent system and plumbing fixtures.The waste and vent system shall be tested by one of the three following alternate methods for evidence or indication of leakage: a)Water test: before plumbing fixtures are connected, all the openings into the piping must be plugged and the entire piping system subjected to a static water test for 15 minutes by filling it with water to the top of the highest vent opening with no evidence af leaking. b)Air test: after all fixtures have been installed, the traps filled with water, and the remaining openings securely plugged, the entire system must be subjected to a 2-inch (manometer)water column air test. c) Flood level test: the entire system must be filled with water to the rim of the water closet bowl (tub and shower drains must be plugged), the test must be sustained for 15-minutes without evidence of leaks. The system must then be unplugged and emptied. The waste piping abov�the water closet bowl must then be tested to show no evidence of leakage when the high fixtures are filled with water and emptied simultaneously to obtain the maximum flow to drain piping. § 3285.605 Gas piping systems. After the appliances are connected,the piping system must be pressurized to not less than 10 inches or more than 14 inches water column (6 to 8 aunces per square inch) and the appliance connections tested for leakage with soapy water or bubble solution. The system must be isolated from the air pressure source and maintain this pressure for not less than ten minutes without showing any drop in pressure. IFGC 406.4(Requi�ed on main line from the gas meter to the connection to the trailer gas piping system) 406.4.1 Test Pressure. ...not less than 25 psig. Where the test pressure exceeds 125 psig, the test pressure shall not exceed a value that produces a hoop stress in the piping greater than 50 percent oi the specified minimum yield strength of the pipe. 406.4.2 Test Duration. ....When testing a system in a single-family dwelling, the test duration shall be permitted to be reduced to 10 minutes... 4Q6.4.3 Test Gauges. ....Test pressure shall be within the middle 50 percent of the test gauge pressure range. § 3285.702 Electrical Testing 1. Continuity test to ensure metallic parts are efFectively bonded, 2. Operational tests of all devices and utilization equipment(except water heaters, electric ranges/furnaces/dishwashers/clothes dryers &washers, and portable appliances)to demonstrate that they are connected and in working order, 3. For electrical equipment installed or completed during installation of the home, electrical polarity checks must be completed. §3280.208 Smoke alarm requirements. Testing and maintenance. (1) Each required smoke alarm installed at the factory must be operationally tested in accordance with the alarm manufacturer's instructions. A smoke alarm that does not function as designed during the test and is not�xed so that it functions properly in the ne� retest rnust be replaced. Tests must be completed by: • Licensed plumbing contractor of record for the project. (Plumbing Tests) • Minnesota-bonded mechanical contractor. (Gas Supply Tests) � Licensed electrical contractor of record for the project. (Electrical Tests) • Minnesota-licensed manufactured horne installer of record, if the installer has been approved by CCLD as capable of completing the on-site for each of the systems. (All Tests Approved to Perform) • Manufacturer's IPIA agent. (All Tests)