HomeMy WebLinkAbout2013-07-10 NAC Mechanical RPZ Report - Garage-Irrigation 07r/�331/2013 14: 50 6514394061 BOARD OF WATER COMMI PAGE 06/06
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Mechanical & Electrical Services www.nao•hvac.com
1001 Lahore Industrial Court,Suite B,Vadnais Heights,Minnesota 55110 tel: 651-490-9888 fax: 651-490-1636
RPZ Report
BACKFLOW PREVENTOR (RPZ) TEST REPORT
JOB ADDRESS: 15- (,)AA - At 41-\U u)c(,(11,n 5so4
OWNER/OCCUPANT/CONTACT PERSON: - (Om/IA \ j_ G
CONTACT PHONE#: r 1 - • — r
,DEVICE LOCATION: 15\61.(Gas-k_ FLOOR#: t ROOM 01
SERVICES WHAT SYSTEM: �,',('i 6(A.( Y\
MAKE: Lc9C( > MODEL:q cArn 1, SIZE: t h:
SERIAL 0: -S
INSTALL DATE: (OVERHAUL DATE: 7—/c-- 013 TEST DATE: /''Ic7 )Q 13
#1 CHECK VALUE RELIEF r #2 CHECK
I'SI/DIFF BPSI/DIFF VALUE
TEST BEFORE REPAIRS OK
FINAL TEST aG) p�'
DESCRIBE REPAIR IF ANY(fl 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): L'J am°_ /COL.", Z-
CERTIFICATION NUMBER: ‘ 0S.?. —6 F
COMPANY NAME: NAC Mechanical &Elec CONTRACTOR LICENSE t/:
COMPANY ADDRESS: 1001 Labore Industrial Ct COMPANY PHONE 0: 651-490-9868
CRY: Vadnn is Height STATE: MN ZIP: 55110 -CONTACT PERSON: Charlie Kistler
ATTACH COMPLETED TEST REPORT TO PLUMBING/GASFITTING/RPZ PERMIT
APPLICATION AND SUBMIT WITH FEE