Haws 9202 - Page 5

Date T1 T2 T3
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
Test Record
Location _______________________
Date T1 T2 T3
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
March
April
May
June
YEAR
YEAR
YEAR
YEAR
YEAR
YEAR
Before you use this chart please make a copy for future testing records.
Caution: When maintaining and adjusting the mixing valve. The delivered flushing fluid temperature shall
be 60°F (15°C) to 95°F (35°C). In circumstances where chemical reaction is accelerated by flushing fluid
temperature, a medical advisor should be consulted for the optimum temperature for each application.
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