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HomeMy WebLinkAbout2013-03-25 Mid-City Mechanical Annual RPZ Test Report - Watts 71136 04/08/2013 14:22 7637868640 MID CITY MECHANICAL PAGE 02/02 ANNUAL TEST REPORT REDUCED PRESSURE ZONE BACKFLOW PREVENTERS DOUBLE CHECK VALVE ASSEMBLIES r' \NUFACTURER Watts MODEL 009M20T SIZE 1" SERIAL# 71136 NAME OF FACILITY Valvoline Instant Oil COUNTY ADDRESS (STREET, CITY, ZIP) 5800 Neal Ave. N., Oak Park Heights, MN Store 496 LOCATION OF DEVICE IN BUILDING Lower Level SERVICES WHAT SYSTEM Main line right after the meter, irrigation is separate CHECK VALVE NO. 1 CHECK VALVE NO. 2 RELIEF VALVE (FOR RPZ ONLY) INITIAL LEAKED ( ) LEAKED ( ) OPENED ATZ_4,PSI TEST CLOSED TIGHT ( ) CLOSED TIGHT (X) REDUCED PRESSURE DID NOT OPEN ( ) DESCRIBE CLEANED ( ) CLEANED ( ) CLEANED ( ) REPAIRS REPLACED ( ) REPLACED ( ) REPLACED ( ) DISC ( ) DISC ( ) DISC. ASSEMBLY ( ) DISC HOLDER ( ) DISC HOLDER ( ) O -RING .. ( ) .. STEM ( ) STEM ( ) STEM^` `' ( ) RETAINER ( ) RETAINER ( ) SPRI 0. ` ( ) 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: -, 0 0 FINAL CLOSED TIGHT ($) CLOSED TIGHT (X) OPENED AT Z - j,PSI TEST REDUCED PRESSURE INITIAL TEST BY DATE SIGNATURE REPAIRED BY DATE SIGNATURE FINAL TEST .BY: MID -CITY MECHANICAL DATE `� `zS• /3 SIGNATURE o,.‹, - .2a..., 9103 DAVENPORT ST. N.E. BLAINE, MN 55449 (763) 786 -8617 PHONE CERT. NO. 0 60i ri fig (763) 786 -8640 FAX