HomeMy WebLinkAbout2001-06-22 St. Paul Regional Water Services RPZ Test Report • REDUCED PRESSURCKFLOW PREVENTE sTEST RORT AND ,,4-��j -
TL,,TABLE DOUBLE CHECKS 61
SAINT PAUL REGIONAL WATER SERVICES
Contact Personrrele
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S Cry: �ti.k. Pk. 14+s Slate:td____Zip:
Serve what system: 0.wx -s-�r''e
vice Location:
Serial Number •
:count Number Make: l 14)RT T . M odel:Oi3M. e: . — `
rpe: D o1_ood Jr A Gap installation Date
stall Date: 5—� � o c)*o
—/ _ �p s Test Date:
,ebuitti Date:
Urea(Valve#1 Check Valve_#2 Differential Pressure Refief Valve
Annual Q d reduced pressure.
o--•- _ Opened at 4'- 1 psid Pressure _�,) _ Pressure Did not open _._...
Y Cleaned Cleaned
n Cleaned _X_ Replaced Replaced
Replaced
R
Disc Disc Disc.Upper
S rn D'ec`Lower
E SD Guide _„_ — Sexing
P Guidde e . .— Pin Retainer Diaphragm,Large
p� Pin Retainer — -- Lower
--` Hinge Pin
1 �_ Hinge Pin —`�' �� tlp�er
N ____ Soot �bm•Smelt
_ Diaphragm ----°
S Diaphragm Other,describe _,,,,,__w__ Lower
Other,describe upper
_ Lower.� z
r� a -5 — Upper
_ — Spacer,Lower
_. her,describe
(___Xj Sign and date Tog
` Q Al -=1�`1 OateTest�
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The above is certified correct. Signed Cam,Number 3�
ilk •
Tested by (?rint Name)) A a�-�,• (i
Company Naiztia: ca,l.� 1cM - • License Number 1q
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Company Telephone Number S 1 7 "3 SSA
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All`sections of this report must be completed. r $30
nai Water Services First $30
Return to: Saint St Regional Devices 2-21 $25
5
84th St E Ste 400 22 and oven'
Saint pout,MN 5510 -1007