Loading...
HomeMy WebLinkAbout2007-02-09 Backflow Preventor (RPZ) Test Report - Norblom Plumbing ......, ....\ A Naomi" logo 2905 Garfield Avenue South 11 II. , a 1 rt Ai , Miinneapolix, MN 55408 , `. e,J ; If 16121827-4033 Fax [612) 827- ; . - State PM# 5065 Minneapolis #788 D �� 1 Backflow Preventor (RPZ) Test Report i LM 5 X07 ' V Site Address: City: City: .• State: Zip: 0 41— g*"‘ ‘& 4s\-- (440 5 Conta Contact Phone: Devic Location: Floor #: Room: 0 Serves What Systr: o 0C, 1.4 toj Make Model Size: I t Vi l l.4. s z .r,J Q►75 1( l Serial #: /(0 Install Date: Overhaul Date: Test Date: #1 Check Valve PSI /Diff Relief PSI /Dill #2 Check Valve Test Before Repairs: a„, ot<, Final Test: I r Describe Repair (If any): Test Performed Af Certification #: ti _4T-1.5,6K-- 036 (. Norblom Plumbing Fax (612) 827 -8129 2905 Garfield Avenue South Web: www.norblomplumbing.com Minneapolis, MN 55408 Email: info@norblomplumbing.com (612) 827 -4033 Jeff Norblom PM #5065 Minneapolis #788 A @ 29115 Garfield Avenue South _ i it III ir Minneapolis, If N 55408 . : _ b 1 16121821-433 Fax_ 18121 827 -8129 State PM# 5065 Minneapolis #788 Backflow Preventor (RPZ) Test Report Si, ©res : � city: bp Ci y: r State: Zip: I. Conta t: Contact Phone: D . e L catio(: J Floor #: • Room: S s hat System: t M ke: Model: Size` / / ( Seria #: (9 YW3SO Install Date: Overhaul Date: Test Date: D c 4 4Q-? 1 #1 Check Valve PSI /Diff Relief PSI /Diff #2 Check Valve Test Before Repairs: fl o t< I 1 . .� Final Test: Describe Repair (If any): j Test Performed b : Certification #: Norblom Plumbing Fax (612) 827 -8129 2905 Garfield Avenue South Web: www.norblomplumbing.com Minneapolis, MN 55408 Email: info @norblomplumbing.com (612) 827 -4033 Jeff Norblom PM #5065 Minneapolis #788