HomeMy WebLinkAbout2013-07-10 NAC Mechanical RPZ Report - Svcs Chiller Feed NMI -� 24 Hour Service
Mechanical&Electrical Services www.nac-hvac.com
1001 Lahore Industrial Court,Suite B,Vadnais Heights,Minnesota 55110 tel: 651490-9868 fax: 651-490-1636
RPZ Report
BACKFLOW PREVENTOR (RPZ) TEST REPORT
JOB ADDRESS: 14gc(1 (QanA p p Box }s-c d(t timie na c
OWNER/OCCUPANT/CONTACT PERSON: C(Jrj&J ( c CE, l
CONTACT PHONE#: e-,('l+� (X �(R P t ? ( (.0040(
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DEVICE LOCATION: /Az/„ cOUt4,1 FLOOR#: L L- J ROOM#:
SERVICES WHAT SYSTEM:C c/kr-
MAICE:kti 45 I MODEL: `1 C 7 I SIZE: I /tZ SERIAL#: 1 C
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INSTALL DATE: 'OVERHAUL DATE: j- oq TEST DATE: 7 j47-07C7/3
#1 CHECK VALUE RELIEF #2 CHECK
PSI/DIFF BPSI/DIFF VALUE
TEST BEFORE REPAIRS OK
FINAL TEST ;— 0 D O 1c
DESCRIBE REPAIR IF ANY(1F THIS IS A NEW INSTALLATION AND REPLACES AN EXISTING DEVICE,
INDICATE THE SERIAL NUMBER OF THE DEVICE REMOVED):
TEST DONE BY(PLEASE PRINT FIRST J FIRST&LAST NAME): L cL
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CERTIFICATION NUMBER: i j 6 fi
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