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Home My WebLink About2006-04-27 Mid-City Mechanical Annual RPZ Test Report - Watts 71136 ..--N ANNUAL TEST REPORT p..., REDUCE RESSURE ZONE BACKFLOW P1 /ENTERS 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 CHECK VALVE NO. 1 CHECK VALVE NO. 2 RELIEF VALVE (FOR RPZ ONLY) INITIAL LEAKED ( y LEAKED ( ) OPENED AT SI TEST CLOSED TIGHT ( ) CLOSED TIGHT (,/4 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 ( ) n 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 ,% �' ,7--f 6, I, DATE t- ,l -a��G SIGNATURE/ � �� . REPAIRED BY DATE SIGNATURE )NAL TEST BY: MID -CITY MECHANICAL DATE 1- SIGNATURE 2- ' 9103 DAVENPORT ST. N.E. BLAINE, MN 55449 (763) 786 -8617 PHONE CERT. NO. a a V 7 (763) 786 -8640 FAX