HomeMy WebLinkAbout2013-04-09 NAC Mechanical RPZ Report - LL Storage Room .
(05/1_1
N � 24 Hour Service
Mechanical & Electrical Services .
www.nac- hvac.com
1001 Labore Industrial Court, Suite B, Vadnais Heights, Minnesota 55110 tel: 651 -490 -9868 fax: 651-490-1636 * k
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RPZ Report
BACKFLOW PREVENTOR (RPZ) TEST REPORT
JOB ADDRESS: y 6 0-1 9 (.cj OC hl, St M 7 (We r NiNN.Q h7C lulj -
OWNER/OCCUPANT /CONTACT PERSON: WaSk, A _54 ca, j � KA e' /a x. (
CONTACT PHONE #: &S) — `3 ./ 3 7 w. c _- ) J
DEVICE LOCATION: 3 Qv> \ I FLOOR #: L C_. I ROOM #: L L 0 (
SERVICES WHAT SYSTEM: 0 (ip O S I v
MAKE: A()01 1(� I MODEL: a e -ZIC� SIZE: +
/Z. SERIAL #: 36, vg.3
INSTALL DATE: 9 (OVERHAUL DATE: TEST DATE: q--q- Do( 3
#1 CHECK VALUE RELIEF #2 CHECK `
i
PSI/DIFF BPSI/DIFF VALUE
TEST BEFORE REPAIRS
OK
FINAL TEST Y - , c.2 -
Q
DESCRIBE REPAIR IF ANY(IF THIS IS A NEW INSTALLATION AND REPLACES AN EXISTING DEVICE,
INDICATE THE SERIAL NUMBER OF THE DEVICE REMOVED):
TEST DONE BY (PLEASE PRINT FIRST & LAST NAME): lu j,e. 4.4 L/
CERTIFICATION NUMBER: (I ;C.).. .? (jF
COMPANY NAME: NAC Mechanical & Elec CONTRACTOR LICENSE #:
COMPANY ADDRESS: 1001 Labore Industrial Ct COMPANY PHONE #: 651- 490 -9868
CITY: Vadn STATE: MN ZIP: 55110 JCONTACT PERSON: Charlie Kistler
ATTACH COMPLETED TEST REPORT TO PLUMBING /GASFITTING/RPZ PERMIT
APPLICATION AND SUBMIT WITH FEE