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Home My WebLink About2002-03-08 Mid-City Mechanical Annual RPZ Test Report - Watts 51202 r ,---. ANNUAL TEST REPORT REDUCED PRESSURE ZONE BACKFLOW I'REVE,N'I'ERS 3'00 'DOUBLE CHECK VALVE ASSEMBLIES MANUFACTURER Watts MODEL 009 SIZE 1/2" SERIAL# S1202 NAME OF FACILITY Valvoline Instant Oil Change COUNTY ADDRESS (Street, City, Zip) 5800 Neal Ave!,' Oak Park Heights, MN LOCA'T'ION 01? DEVICE IN BUILDING Check Valve No. I Check Valve No. 2 Relief Valve 9,L (For RI'Z Only) al • Leaked ) Leaked ( ) Opened At 21 ZPSI Closed Tight O Closed Tight Pressure g ( ) Reduced 1 � cssure Did Not Open ( ) DESCRIBE Cleaned REPAIRS ( ) Cleaned ( ) Cleaned ( ) Replaced: ( ) Replaced: ( ) Replaced: Disc ( ) Disc ( ) ( ) Disc Assembly ( ) Disc holder ( ) Disc Holder Stem ( ) Stem ( ) O -Rings ( ) ( ) Stem ( ) Retainer ( ) Retainer 0-Rings ( ) Spring ( ) h s ( ) 0-Rings ( ) Diaphragm ( ) Seat ( ) Seat ( ) Seat Spring ( ) Spring ( ) 1 k ( ) Spacer ( ) Guide ( ) Guide ( ) Other-- - Bushings ( ) Bushings ( ) Describe ( ) b escribe Below: Other -- ( ) Other - -- ( ) Describe Below: Describe Below: SPECIAL COMMENTS: Final Closed Tight b ( ) Closed Tight ( ) Opened , Test TcuedAt PSI Reduced Pressure INITIAL '[ EST BY �( - 7277 - z AT UA'I'F, 3 0 Z SIGNATURE 40 j II REPAIRED BY DATE SIGNATURE FINAL TEST BY: Mid-City Mech. Corp. DATE SIGNATURE q l0"3 -91 St. NE Blaine, MN 55449 2- 757 -7100) CERT # D/Z SZ�' ,