HomeMy WebLinkAbout2014-08-18 Backflow Preventor (RPZ) Test Report - Bldg. 72 Blower- Chemical -Rebuild (. Sep. 5. 2014 T 8' 54AM C. Wenzel Plumbing No. 2298 P. 1
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1959 ShawneeRoad, Suite 130, Eagan, MN 55122
DEVICE ADDRESS ,•` 4 ,/,/`. _,/-4/1
Ad SERVICE NAME I i- rN,i'l 0e''f y j4de,y An/ 1
CONTACT PERSON I "feat (f7 Age. 1•
TELEPHONE I <-/" fir, 2-.3 fo 6 1
BILLING ADDRESS I I
CITY I �� F,4,eve //e;p4Zr" I
STATE, ZIP CODE I /1 ,■V, 5542- I
DEVICE LOCATION I S/QQ 72- .F49 7/1.4 •'c , '7� I
DEVICE SERVES WHAT SYSTEM [ /t- /41,41/;4 ,/ c/ ,4I ' I
SERIAL NUMBER ), -? 7ly?i I TEST YEAR
MAKE 14/94a 1 I 1st
j ¶ODEL l eAe.g I I 2nd
SIZE I / J1t 1 1 3rd
INSTALL DATE I pv/'1� 1 I 4th
CHECK VALVE#11-71-1 1/(REBUILD
CHECK VALVE #2I V I I New Install
PRESS. DIET.ACROSS #1 '1,9-
PRESS. DYES.ACROSS #2 �.U Test Date; Or/9
PRESS. DYES. RELIEF OPEN)y.o I
Describe Repair; � g
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EREBY CERTIFY THE FOREGOING DATA TO BE CORRECT AND THAT THE TESTED DEVICE IS
FUNCTIONING WITHIN THE LIMITS OF THE STANDARDS
BY: Brook Danner CERT.# 329018