HomeMy WebLinkAbout2019-05-06 Mid-City Mechanical Annual RPZ Test Report - Watts 71136ANNUAL TEST REPORT
REDUCED PRESSURE ZONE BACKFLOW PREVENTERS
DOUBLE CHECK VALVE ASSEMBLIES
MANUFACTURER Watts MODEL 009M20T SIZE 1" SERIAL# 71136
NAME OF FACILITY Valvoline Instant Oil COUNTY
ADDRESS (STREET, CITY, ZIP) 5800 Neal Ave. N., Oak Park Heights, MN Store #96
LOCATION OF DEVICE IN BUILDING Lower Level
SERVICES WHAT SYSTEM Main line right after the meter, irrigation is separate
INITIAL
TEST
DESCRIBE
REPAIRS
CHECK VALVE NO. 1 CHECK VALVE NO.2 RELIEF VALVE
(FOR RPZ ONLY)
LEAKED ( ) LEAKED
CLOSED TIGHT (�� CLOSED TIGHT
�f
CLEANED
REPLACED
DISC
DISC HOLDER
STEM
RETAINER
O -RINGS
SEAT
SPRING
GUIDE {
BUSHINGS
OTHER --
DESCRIBE BELOW:
SPECIAL COMMENTS:
CLEANED {
REPLACED {
DISC
DISC HOLDER {
STEM
RETAINER {
O -RINGS
SEAT
SPRING {
GUIDE {
BUSHINGS {
OTHER-- {
DESCRIBE BELOW:
OPENED AT PSI
REDUCED PRESSURE
DID NOT OPEN ( )
CLEANED
REPLACED
DISC. ASSEMBLY
O -RINGS
STEM
SPRING
DIAPHRAGM
SEAT
SPACER
OTHER ---
DESCRIBE BELOW:
FINAL CLOSED TIGHT -'r-+ CLOSED TIGHT ) OPENED AT - QPSI
TEST
INITIAL TEST BY
REPAIRED
BY
REDUCED PRESSURE
DATE SIGNATURE
DATE J SIGNATURE
FINAL TEST BY: MID -CITY MECHANICAL DATE
9103 DAVENPORT ST. N.E.
BLAINE, MN 55449 (763) 786-8617 PHONE
(763) 786-8640 FAX
SIGNATURE
CERT. N0._