HomeMy WebLinkAbout2013-07-02 NAC Mechanical RPZ Report - Svcs Cooling Tower Make-up Y�
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24 Hour Service
Mechanical& Electrical Services www.nac-hvac.com
1001 Lahore Industrial Court,Suite B,Vadnais Heights,Minnesota 55110 tel: 651-490-9868 fax:,651-490-1636
RPZ Report
BACKFLOW PREVENTOR (RPZ) TEST REPORT
JOB ADDRESS: q L ( ate` 4 {/ Po Bt's(d 54i l I t 011,1 53 c
OWNER/OCCUPANT/CONTACT PERSON: 6, d (
CONTACT PHONE#: �tk � '�.�Z CO 2 I"' _ (t:
DEVICE LOCATION:LOCATION: t/\`./4 kn FLOOR#: I ROOM if: 'f C
SERVICES WHAT SYSTEM: )L( kt_ 4Of�.Rle( (a .C''
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MAKEVC/411511( fM !b? SIZE: 3/11
SERIAL#. /5.0 1 6
INSTALL DATE: !OVERHAUL DATE:1 Z l 7 TEST DATE: #] -,)c/3
#1 CHECK VALUE RELIEF in CHECK
PSI/DIFF BPSI/DIFF VALUE
TEST BEFORE REPAIRS OK •
FINAL TEST '("D 6k
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): J)^ ti eS (
CERTIFICATION NUMBER: f �� `J F
COMPANY NAME: NAC Mechanical&Elec CONTRACTOR LICENSE#:
COMPANY ADDRESS: 1001 Labore Industrial Ct COMPANY PHONE#: 651-490-9868
CITY: Vadnais Height STATE: MN ZIP: 55110 CONTACT PERSON: Charlie Kistler
ATTACH COMPLETED TEST REPORT TO PLUMBING/GASFITTING/RPZ PERMIT
APPLICATION AND SUBMIT WITH FEE