HomeMy WebLinkAbout2013-07-02 NAC Mechanical RPZ Report - Svcs Chillers kr
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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
RPZ Report
BACKFLOW j Q (n
Q PREVENTOR (RPZ) TEST REPORT
JOB ADDRESS:114 1� 1 . r 5-1.91/r P(i 81%
OWNER/OCCUPANT/CONTACT PERSON: O►d/ k 6,7t�,il'� g('J(.1 'eyl, r
CONTACT PHONE#: '�-�i 47 & „ i o -62d63 -7
DEVICE LOCATION:th. d &e` phi, FLOOR#: 1 fi— I ROOM#: V(L?
SERVICES WHAT SYSTEM: 6-k( ter 5
,MAKE: le k o TMODEL: i I SIZE:1L! o( SERIAL#: AL (7 X of
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INSTALL DATE: OVER UL DATE: /(J)7-der TEST DATE:
#1 CHECK VALUE RELIEF #2 CHECK
PSI/DIFF BPSI/DIFF VALUE
TEST BEFORE REPAIRS OK
FINAL TEST /i1, 0 (- g 6
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): tihrt&Q IC"\
CERTIFICATION NUMBER: 633- 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