HomeMy WebLinkAbout2019-05-06 Mid-City Mechanical Annual RPZ Test Report - Irrigation - Zurn-Wilkins A376240ANNUAL TEST REPORT
REDUCED PRESSURE ZONE BACKFLOW PREVENTERS
DOUBLE CHECK VALVE ASSEMBLIES
MANUFACTURER Zurn/Wilkins MODEL 375RD SIZE I" SERIAL# A376240
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 Basement
SERVICES WHAT SYSTEM Irri
CHECK VALVE NO. 1 CHECK VALVE NO.2 RELIEF VALVE
(FOR RPZ ONLY)
INITIAL LEAKED ( } LEAKED { )
TEST CLOSED TIGHT (jC} CLOSED TIGHT )
d
OPENED AT PSI
REDUCED PRESSURE
9. 9 DID NOT OPEN ( )
DESCRIBE CLEANED
REPAIRS 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:
CLEANED
REPLACED
DISC. ASSEMBLY
O -RINGS
STEM
SPRING
DIAPHRAGM
SEAT
SPACER
OTHER ---
DESCRIBE BELOW:
FINAL CLOSED TIGHT CLOSED TIGHT OPENED AT ' , PSI
TEST 1 9 6 REDUCED PRESSURE
INITIAL TEST BY DATE � 6 �'7 SIGNATURE
REPAIRED /
BY DATE _ ~ SIGNATURE
FINAL TEST BY: MID -CITY MECHANICAL DATE SIGNATURE
9103 DAVENPORTST. N}
BLAINE, MN 55449 763 786-8617 PHONE CERT. NO.
(763) 786-8640 FAX