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Home My WebLink About2008-03-08 Mid-City Mechanical Annual RPZ Test Report - Watts 51202 • -- ' ANNUAL TEST REPORT _ REDUCE/, PRESSURE ZONE BACKFLOW Pk— VENTERS DOUBLE CHECK VALVE ASSEMBLIES NUFACTURER Watts MODEL 009 SIZE %2" SERIAL# 51202 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 Store room main floor CHECK VALVE NO. 1 CHECK VALVE NO. 2 RELIEF VALVE (FOR RPZ ONLY) 3. INITIAL LEAKED r ( )LEAKED ( ) OPENED AT SI TEST CLOSED TIGHT (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: FINAL CLOSED TIGHT ( ) CLOSED TIGHT ( ) OPENED AT PSI TEST REDUCED PRESSURE INITIAL TEST BY fVl ;(c e F-4 c i 1) C 4 DATE SIGNATURE - -- V/ 3 •-Y--o&- REPAIR BY DATE SIGNATURE V.LAL TEST BY: MID -CITY MECHANICAL DATE 3 - y -° S SIGNATURE - ,2 9103 DAVENPORT ST. N.E. BLAINE, MN 55449 (763) 786 -8617 PHONE CERT. NO. /� c! 7 ,d/"- (763) 786 -8640 FAX b