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HomeMy WebLinkAbout2015-09-18 Backflow Preventor (RPZ) Test Reports - Norblom Plumbing . .L kk pLUM : Phone(612)827-4033 .,!r 1465 Selby Avenue Fax(651)340-8631 St.Paul,MN 5510Z‘Lte..C.L)S www.norblomplumbing.com Backflow Preventor (RPZ) Test Report Site Addr s: City: a ii. bel , -111: St-fe: Zia: its i. A. lb. ■ i.0 ■�, • • tact: Contact Phone: De ' oc Lion: � Floor#: l STAysfcrrr • Make: Model: • Size: \jai,( Serial#: '' ' t cRif •, Last Test — 7' Install Date: Overhaul Date: Test Date: -c r9 9- g-/5- " • #1 Check Valve PSI/Diff Relief PSI/Diff .#2 Check Valve I Test Before Repairs: I Final Test: O G 4 (4. x •Describe Repair/any pertinent notes(If any): C 1 . doott.-- i Test Performed by::e �sX�-� Certificati(Icy, 3�n �_ r---+AGES (a. � 10 ` 1 Norbiom Plumbing Web: ww.norblompiumbing.com 1465 Selby Avenue Email:infognorblomplumbing com St. Paul, MN 55104 Jeff Norbiom PM061521 Mpis PCM788 (612)827-4033 Fax(651)340-8631 I 1 P pLU s . Phone(612)827-4033 r 1465 Selby Avenue Fax(651)340-8631 St.Paul,MN 55104 S www.norblomplumbing.com ackfow Preventor (RPZ) Test Report Site Address:; � City:0-4. cla3P- K.k . _ Z14 State: - Zip: Contact: Contact Phone: ' tit4"4ce:V . .• De 'ce Location: • Floor#: Se e What System: I� \jk01/4N • M 4 tkG rj Ly r1.1 Model: r Size: I K• Serial#: , . 161{4tgeti . • Last Test Date:� '� •Install Date: Overhaul Date: Test Date: r s 9-r6 /5 9-1 -ir • #1 Check Valve PSI/Dill Relief PSI/Diff .#2 Check Valve I Test Before Repairs: 1 I Final Test: ct Z VI. ' ,C._611---W • Describe Repair/any pertinent notes(If any): • c- eL.A.A.__ . . Test .erformed b Certific 'o�a Norblom Plumbing Web: ww,norblomplumb/ngcom 1465 Se/by Avenue Email:info@norblomplumbing com St. Paul, MN 55104 Jeff Norb/om PM061521 Mp/s PCM788 (612)827-4033 Fax(651)340-8631