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HomeMy WebLinkAbout2004-03-08 Mid-City Mechanical Annual RPZ Test Report - Watts 51202 -^.• ANNUAL TEST REPORT P'N ' � ' REDUC,_,.., PRESSURE ZONE BACKFLOW PREVENTERS DOUBLE CHECK VALVE ASSEMBLIES �.NUFACTURER Watts MODEL 0 0 9 SIZE 1 / 2 " SERIAL# S1 2 0 2 NAME OF FACILITY Valvoline Instant Oil Change COUNTY ADDRESS (STREET, CITY, ZIP) 5800 Neal Ave. N. - Oak Park Heights , MN LOCATION OF DEVICE IN BUILDING CHECK VALVE NO. 1 CHECK VALVE NO. 2 RELIEF VALVE (FOR RPZ ONLY) INITIAL LEAKED ( ) LEAKED ( ) OPENED AT PSI TEST CLOSED TIGHT ( ) CLOSED TIGHT ( ) REDUCED PRESSURE DID NOT OPEN ( ) DESCRIBE CLEANED ( ) CLEANED (X) CLEANED (N ) REPAIRS REPLACED (?c) REPLACED ( ) REPLACED ( ) DISC ( ) DISC ( ) DISC. ASSEMBLY ( ) DISC HOLDER ( ) DISC HOLDER ( ) 0-RINGS (X ) 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: _4-- 74 ye4 ©U �- fr v f FINAL CLOSED TIGHT (ii) CLOSED TIGHT (t4 OPENED AT 3 g PSI TEST REDUCED PRESSURE INITIAL TEST BY DATE SIGNATURE REPAIRER B /VI i k , 0 T C k DATE 3 4 b 4 SIGNATURE FINAL TEST BY: MID -CITY MECHANICAL DATE 3 - 5' SIGNATURE I 9103 DAVENPORT ST. N.E. BLAINE, MN 55449 (763) 757 -7100 PHONE CERT. NO. ' .Q.. cf 7` (763) 786 -8640 FAX