Laboratory Evaluation Report for: Dielectric Pipe Unions

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1 American Society of Sanitary Engineering Seal (Certification) Program Laboratory Evaluation Report for: Dielectric Pipe Unions Tested under ASSE Standard 1079 Issued: September, 2005 Laboratory File Number Manufacturer Model No. Address Serial No. Other Identification Markings Size General information and instructions for the testing engineer: Within the text there may be items which are only advisory to conditions which experience indicates could be troublesome. It is not for evaluation related to acceptance of the product. There may be other items for which the judgment of the test engineer will be involved. Should there be a question of compliance with that provision of the standard, a conference with the manufacturer should be arranged to enable a satisfactory solution of the question. Should disagreement persist and compliance remain in question by the test agency, the agency shall, if the product is in compliance with all other requirements of the standard, file a complete report on the questionable items together with the test report, for evaluation by the ASSE Seal Control Board. The Seal Control Board will then review and rule on the question of compliance with the intent of the standard item involved. Documentation of material compliance must be furnished by the manufacturer. He shall furnish to the testing agency, a bill of material which clearly identifies the material of each part included in the product construction. This identification must include any standards which relate thereto. Page 1 of 5 pages (2005)

2 Product Name Model Number Size(s) Date Submitted for Review Date Review Complete Were the test units production models? Yes No or prototypes? Yes No Section I 1.0 General 1.1 Application Is the purpose of the device, as described by the manufacturer, as stated in this section? Yes No Questionable 1.2 Scope Does the device conform to the product described in the standard? Yes No Questionable Size Range. Does the device comply with the sizes stated? Yes No Section II Pressure and Temperature Range. What is the maximum pressure and temperature as stated by the manufacturer? psi ( kpa) F ( C) 2.0 Test Specimens 2.1 State the quantity of devices per size and model provided for the evaluation: 2.2 How many devices were utilized during the laboratory evaluation? If more than one (1) device was used, state why an additional device was utilized. Page 2 of 5 pages (2005)

3 Section III 2.3 Were assembly drawings, installation drawings and other technical data necessary to determine compliance with this standard submitted to the laboratory? Yes No Were these drawings and other date reviewed in the laboratory? Yes No 3.0 Performance and Compliance Testing 3.1 Hydrostatic Test What was the pressure used for this test? psi ( kpa) The pressure was applied for minutes. In compliance? Yes No 3.2 Dielectric Test What was the measure of micro amps at a voltage of 600 AC? What was the measure of micro amps at a voltage of 2000 DC? In compliance? Yes No Questionable 3.3 Deterioration at Manufacturer's Extreme of Temperature and Pressure Ranges What was the water temperature used for this test? F ( C) What was the water pressure used for this test? psi ( kpa) The test period was Was water at 40.0 F± 1.0 F (4.4 C± 0.6 C) run through the device at the manufacturer's maximum rated pressure for one (1) hour immediately following the 80 hour test? Yes No In compliance? Yes No Page 3 of 5 pages (2005)

4 Section IV 4.0 Detailed Requirements 4.1 Did the solder and fluxes used contain more than 0.2% lead? Yes No Did any metal alloys contain over 8% lead? Yes No Did metallic materials meet all the material requirements of the applicable ASME standards? Yes No 4.2 Markings List the markings found on the device: a. b. c. How were the markings applied? 4.3 Installation Instructions Were installation instructions including specific instructions on how to prevent damage to the gasket during the soldering or welding process packaged with the device? Yes No Page 4 of 5 pages (2005)

5 TESTING AGENCY ADDRESS PHONE: FAX: TEST ENGINEER(S) We certify that the evaluations are based on our best judgments and that the test data recorded is an accurate record of the performance of the device on test. Signature of the official of the agency: Title of the official: Date: Signature and seal of the Registered Professional Engineer supervising the laboratory evaluation: Signature Seal Page 5 of 5 pages (2005)

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