HomeMy WebLinkAbout2013-07-03 NAC Mechanical RPZ Report - Garage-Wash Bay 07/31/2013 14: 50 6514394061 BOARD OF WATER COMMI PAGE 05/05
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Mechanical & Electrical Services www.nac-hvac.com •
1001 Labore industrial Court,Suite B.Vadnals Heights,Minnesota 55110 tel: 651-490-9868 fax 651-490-1636
RPZ Report
BACKFLOW PREVENTOR (RPZ) TEST REPORT
JOB ADDRESS:
OWNER/OCCUPANT/CONTACT PERSON: / 4, , 629C .L 1 L
CONTACT PHONE I: � 6.6.A Otij 4� -6 5(-.
DEVICE LOCATION: Ct.E_t FLOOR#: 't I ROOM II:
SERVICES WHAT SYSTEM: LOCI.S'L 7.
MAKE: Iti k\A 4, MODEL: 5 }(L SIZE: 3�� oc SERIAL II: Q,36 oi--- L(
INSTALL DATE: OVERHAUL DATE:--/-er-?C Il TEST DATE: 7-3 7:20 (3 _
#1 CHECK VALUE RELIEF #2 CHECK fi
PSUDIFF BPSI/DIFF VALUE
TEST BEFORE REPAIRS OK
FINAL TEST -L -
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): /f J1(lQ SgyeN ka V(1 C)--\.
CERTIFICATION NUMBER: ( 03 3 - 6F
COMPANY NAME: NAC Mechanical & Elec CONTRACTOR LICENSE#:
COMPANY ADDRESS: 1001 Labore Industrial Ct COMPANY PHONE rr: 651-490-9868
CITY: Vadnnis Height STATE: MN ZIP: 55110 „CONTACT PERSON: Charlie Kistler
ATTACH COMPLETED TEST REPORT TO PLUMBING/GASFITTING/RPZ PERMIT
APPLICATION AND SUBMIT WITH FEE