HomeMy WebLinkAbout2013-07-10 NAC Mechanical RPZ Report - Svcs Softener? _______ _ ,
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Fl-'V� 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
RPZ Report
BACKFLOW PREVENTOR (RPZ) TEST REPORT ,
JOB ADDRESS:Ill4L'I4 ( O4 � V_IV PO I ]UX 6 /5 t(1(7t I( 1 A5so g,„)
OWNER/OCCUPANT/CONTACT PERSON:tat 5)1_,( tom Y. evIdeft,fitte,A yV (w4.for
CONTACT PHONE#: �/(•(� ''Sa.t Ott)(- 2 //5 1.-14tO - (0 t)
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DEVICE LOCATION:ilh-edpOivt.60,I al/V\ ( FLOOR#: / I ROOM#: 14 Z
SERVICES WHAT SYSTEM: t' r
,+� It MAKE:Wes-ft 5 JMODEL:CO'(14k3 I SIZE:1 SERIAL#: 6'3 62 I;
INSTALL DATE:/0---620-0)(9/62 f OVERHAUL DATE: TEST DATE: `•7- /CY -d o Is 3
#1 CHECK VALUE RELIEF #2 CHECK t
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PSI/DIFF BPSI/DIFF _ VALUE
, TEST BEFORE REPAIRS OK
FINAL TEST 1, 9 ,, ak ,
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): ale .�eA44 kOl U c y
CERTIFICATION NUMBER: .t�j;-g r \
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•COMPANY NAME: NAC Mechanical&Elec CONTRACTOR LICENSE#:
COMPANY ADDRESS: 1001 La bore 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