Flow Test Information Sheet

Note: ERFPD recommends a two-hydrant test

1. Reason For Test: Design Base
Other
2. Address of Property: ________________________________________________________________
3. Date & Time of Test: Date: _____________
Time: _____________ (am) (pm)
4. Test Conducted by: _________________________________________________________________
Name

Title

Affiliation

5. Test Witnessed by: __________________________________________________________________

Name

Title

Affiliation

6. Source of Water Supply: Gravity

Pump
Other: _______________________________
7. Name of Water District: _____________________
Fire District: __________________________
8. Is water supply provided with PRV STAs
Yes No
(If so, what is PRV outlet setting? ______________PSIG) Make/Model of Hydrants: __________________________
9. Area Map: (Draw Sketch showing property location; bounding streets and names, North Arrow, location of fire main tap
to subject building, hydrant locations and identification numbers, distances from hydrants to property, elevations of hydrants
and property floors or grade, all water mains, sizes and interconnection valves etc.)

10. Flow Test Data - Date Gages Last Calibrated: ____________________

Flow at Hydr.
Number

Static at Hydr.
Number

Static
PSIG

Residual
PSIG

11. Signed: _____________________

12. Witness: ____________________
At completion of test hydrants were verified to be in the off
position and observed to drain down. Initials: ________

Flow
GPM

Outlet
Coefficient

Adjusted
GPM

Pitot
PSI