HomeMy WebLinkAbout2012-08-22 Backflow Preventor (RPZ) Test Report - Boiler Room - Chiller Feed Test Sheet
Client Presbyterian Homes pipe Dream
Address 5450 Nolan Parkway
City Oak Park Heights
MN MN plumbing Inc
Zip 55082
Owner /Contact Presbyterian Homes 61296-4198
Phone 651 -775 -5859 Jim Armstrong
Fax TEST #
Municipality Test Date: 08/22/2012
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Location of Device: Boiler Room
Serves: Chiller Feed
Make and Model Size Serial # Yr
Wilkins 975XL .75" 1690679 Rbld
Check Check Pres. Dif Across Pres. Dif Across Strainer
Valve #1 Valve #1 Check Relief Valve
#2
Test Before Leaked Leaked psi psi None ( )
Repair Closed- Closed Cleaned ( )
Describe Repair: 5 Year Rebuild
Final Test Leaked Leaked _9.0 psi _ 3.8 psi
Closed Closed\
Materials Used:
Certification:
I hereby certify the foregoing data to be correct and that the tested device is functioning
within the limits of the standards. " °` N
Firm Name: Pipe Dream Plumbing Inc. 3333 Emerson Ave S, Mpls., MN 5408
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By: Thomas Sidla Backflow Tester Certification # 063692 -BF
Remarks:
Pipe Dream Plumbing, Inc 3333 Emerson Ave S, Mpls., MN 55408 Fax: 763 - 434 -4103
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