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HomeMy WebLinkAbout2011-04-04 Mid-City Mechanical Annual RPZ Test Report - Watts 71136 04/05/2011 14:40 7637868640 MID CITY MECHANICAL PAGE 02/02 ANNUAL TEST REPORT REDUCED PRESSURE ZONE BACKFLOW PREVENTERS DOUBLE CHECK VALVE ASSEMBLIES MANUFACTURER Watts MODEL 009M2QT 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 CHECK VALVE NO. 1 CHECK VALVE NO. 2 RELIEF VALVE (FOR RPZ ONLY) INITIAL LEAKED ( ) LEAKED ( ) OPENED AT PSI TEST CLOSED TIGHT (X) CLOSED TIGHT ( 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: N - O o-e c KaLISL ; 020 13 FINAL CLOSED TIGHT ( ) CLOSED TIGHT ( ) OPENED AT PSI TEST REDUCED PRESSURE INITIAL TEST BY = ' q- 11 SIGNATURE i'�11u. �.I cr�+n.a..� DATE REPAIRED BY DATE SIGNATURE FINAL TEST BY: MID -CITY MECHANICAL DATE SIGNATURE 9103 DAVENPORT ST. N.E. BLAINE, MN 55449 (763) 786 -8617 PHONE CERT. NO. c% ?i 4 6 F (763) 786 -8640 FAX