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Home My WebLink About2016-03-23 Mid-City Mechanical Annual RPZ Test Report - Irrigation - Zurn-Wilkins A376240 ANNUAL TEST REPORT REDUCED PRESSURE ZONE BACKFLOW PREVENTERS DOUBLE CHECK VALVE ASSEMBLIES MANUFACTURER Zum/Wi lkins MODEL 375RD SIZE 1" SERIAL# A376240 NAME OF FACILITY Valvoline Instant Oil COUNTY ADDRESS (STREET, CITY, ZIP) 5800 Neal Ave. N., Oak Park Heights, MN Store 496 LOCATION OF DEVICE IN BUILDING Basement SERVICES WHAT SYSTEM Irrigation CHECK VALVE NO. I CHECK VALVE NO. 2 RELIEF VALVE (FOR RPZ ONLY) INITIAL LEAKED ( ) LEAKED ( ) OPENED AT2..YSI FEST CLOSED TIGHT ( ( ) CLOSED TIGHT ( X ) REDUCED PRESSURE DID NOT OPEN ( ) DESCRIBE CLEANED ( ) CLEANED ( ) CLEANED ( ) REPAIRS REPLACED ( ) REPLACED ( ) REPLACED ( ) DISC ( ) DISC ( ) DISC. ASSEMBLY ( ) DISC HOLDER ( ) DISC HOLDER ( ) 0-RINGS ( ) STEM ( ) STEM ( ) STEM ( ) RETAINER ( ) RETAINER ( ) SPRING ( ) 0-RINGS ( ) 0-RINGS ( ) DIAPHRAGM ( ) SEAT ( ) SEAT ( ) SEAT ( ) SPRING ( ) SPRING ( ) SPACER ( GUIDE ( ) GUIDE ( ) OTHER--- ( ) BUSHINGS ( ) BUSHINGS ( ) DESCRIBE BELOW: OTHER-- ( ) OTHER-- ( DESCRIBE BELOW: DESCRIBE BELOW: SPECIAL COMMENTS: FINAL CLOSED TIGHT ( ) CLOSED TIGHT ( k ) OPENED AT,?_ PSI TEST REDUCED PRESSURE INITIAL TEST BY k,"'Fi‘ DATE A - /(z, SIGNATURE \ REPAIRED BY DATE_ SIGNATURE FINAL TEST BY: MID-CITY MECHANICAL DATE 4" I SIGNATURE 9103 DAVENPORT ST. N.E. BLAINE, MN 55449 (763) 786-8617 PHONE CERT. NO. (763) 786-8640 FAX