HomeMy WebLinkAbout2018-07-10 RPZ Test Report JUL/23/2018/MON 11 : 00 AM CORPORATE MECHANICAL FAX No, 7635333464 P. 002
REDUCED PRESSURE BACKFLOW PREVENTER TEST REPORT
AND TESTABLE DOUBLE CHECKS
' Contract Person/Tele:
Service Name: �.c.Q�i Ssc,aP-
Address: 5265 kr-u e City:c Peri(- 'State:Min Zip:
Device Location: ,51.,e4--ehi>>d166 Serve what system: t-��-►, r�5�►�Y'
Account# Serial# 6,5-5?az)
Type: �7��CL
Install Date: Make: r-��Ilta-„1 Model.
Size:
Air Gap Installation Date:
Rebuild Date:
Test Date: 7 i O- D 8
Annual Check Valve#1 Check Valve#2 Differential Pressure Relief Valve
Report Pressure �•0 , Pressure 7.g Opened at 5. I psid reduced pressure
Did not open
Repairs:
( X ) Sign and date Tag �r��l
The above is certified correct. Signed 4�.— -
Date tested 7-P®-V018
Tested by (Print Name) ada rotsrA Certification Number eirn 'qa7
ORPORATE
MECHANICAL
5114 Hillsboro Avenue North
New Hope, MN 55428
Fhone:(763) 533-3070
Fax (763)533-3464