HomeMy WebLinkAbout2013-07-03 NAC Mechanical RPZ Report - Svcs Generator u%
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24 Hour Service
Mechanical& Electrical Services www.nac-hvac.com
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1001 Lahore Industrial Court,Suite 8,Vadnais Heights,Minnesota 55110 tel: 651-490-9868 fax 651-490-1636
RPZ Report
BAC,,KFLO lW_PRCEj�VE/NTO�R (RPZ) TEST REPORT
JOB ADDRESS: ,141141 (Or}/lC s (!1/ fon BOK G ; �--k((GE.�Uj�4 /t A. S-sOgS)
OWNER/OCCUPANT/CONTACT PERSON: t1•r,��_ (fit Ci\O
CONTACT PHONE#: k a ]��642_ (r s)- 2!3c5 - (q�
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DEVICE LOCATION:i •cf,Mrn ,C`C ( FLOOR#: LL I ROOM#: CYco
SERVICES WHAT SYSTEM: rojtorr-
MAKE:tet 4 I MODEL: f1 I SIZE: 1 )17,_ SERIAL :
INSTALL DATE: OVERHAUL DATE: fa-,,,n—()c f TEST DATE: 7 j e 0 1-3'
#1 CHECK VALUE RELIEF #2 CHECK
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PSI/DIFF BPSI/DIFF VALUE
TEST BEFORE REPAIRS OK
FINAL TEST -„C
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): tL C,{ -5-041.1((iv
CERTIFICATION NUMBER: (3O3 3--6 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