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HomeMy WebLinkAbout2000-03-20 Mid-City Mechanical Annual RPZ Test Report - Watts 51202 1 ANNUAL TEST REPORT REDUCED PRESSURE ZONE BACKFLOW PREVENTERS 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 LOCATION OF DEVICE IN BUILDING Check Valve No. 1 Check Valve No. 2 Relief Valve (For RPZ Only) Initial • • - Leaked ( ) Leaked ( ) Opened At 3, 2 PSI Test Closed Tight (X) Closed Tight x g (k) Reduced Pressure Did Not Open ( ) DESCRIBE Cleaned ( ) Cleaned ( ) Cleaned ( ) REPAIRS Replaced: ( ) Replaced: ( ) Replaced: ( ) Disc ( ) Disc ( ) Disc Assembly ( ) - p ©R O n/� r a Disc Holder ( ) Disc Holder ( ) 0-Rings ( ) L5 1J 15 Stem ( ) Stem ( ) Stem Retainer ( ) Retainer 1 • g ( ) 0-Rings g �s ( ) 0-Rings ( ) Spring in ( ) Diaphragm ( ) - APR 2 8 Seat ( ) Seat ( ) Seat ( ) Spring ( ) Spring ( ) Spacer ( ) Guide ( ) Guide ( ) Other-- - s ( ) Bushings ( ) Bushings ( ) Describe Below: Other -- ( ) Other - -- ( ) Describe Below: Describe Below: SPECIAL COMMENTS: Final Closed Tight ( /) Closed Tight (,)-- ) Opened At Z PSI Test • Reduced Pressure INITIAL TEST BY ,.-J ( 1 �67 DATE 3- z -po SIGNATURE . D REPAIRED BY DATE SIGNATURE FINAL TEST BY: Mid-City Mech. Corp. DATE SIGNATURE 9107 Davenport St. NE CERT if .0/Z.,52. r Blaine, MN 55449 (612- 757 -7100)