Loading...
HomeMy WebLinkAbout2015-10-01 RPZ Report - Dad's Plumbing - Rebuild Scandia, MN Reduced Pressure Backflow Notification of required RPZ inspection--- Zone Preventer Test Report Occupant : UAUe y U e k) �o t,`t► 4 A Contact Name: 5 i// 601 c Site Address: 14 gg() -5.-"Va Si,No, + 2- Contact Phone: C/2--1-73 2-- 3 2-2--5 Owner: OAtLly U;ekl Saw`rk " N© A Contact Address: Contact City, St., Zip: Device Location:'i V1 ya v'd kvt krr -Q Serves What System: LAtt>V S`9V'LI"! t.'e✓, Make:t vi(14145/?-K 4-4'`A Model: g75-Xl- Size: 2- " Serial#: I/.SBq/y Test Date: 1C /45- Install date: Current Rebuild Date: /4)411, 5 Next Rebuild Due Date: Check Valve#1 Check Valve#2 Pressure Differential Leaked Leaked Relief Valve Opened at Closed ) Closed x 2. 6 PSI R? I/ Ps;d Describe repairs: r.Z4.b "k -- zv+114 5 14i# I2-\ 111-i ' 75-Y L. Tag signed and dated X The above is ce ' ed co Signature: Certification Number: C3 F O lam`( 2-1. 1 Tested by (Print Name): La_v^vy V'ma- License Number: PCS 4/yg4e, Company Name:Pa dS ?1 k 141 19'.044/ Phone Number: ‘j//-113 3-7-z)95— _ Z '95—