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HomeMy WebLinkAboutRPZ Test 5/15/2007 TEST AND MAINTENANCE REPORT FORM RPZ - Reduced Pressure Zone Assembly - RPZ 3415 SPRING GL YN, PRIOR LAKE GLEN WATER WEST Date:)+-- J.r- 0'/ Model f1r~ L Serial# W150568 Address: Owner: Make WI 975XL INITIAL TEST OF DEVICE: Size 2 Check Valve #1 Leaked [ ] Closed t<J Pres. Oil #1 Check: I. t PSI Pres Oil Relief Opens '1. ..~ PSI Strainer: None [I( Cleaned [ ] I Check Valve #2 MAINTENANCE OF DEVICE: Leaked ( ) Clos~ PSI I Check Valve #1 Check Valve #2 Cleaned: Cleaned: Repaired: Repaired: CHANGED OR NEW DEVICE INSTALLED: Date: I Device Type: Model: I Manufacturer: Serial No.: Size: FINAL TEST: Check Valve #1 Pres. Oil #1 Check: Strainer: None [ ] Leaked ( ] Closed ( ] PSI Pres Oil Relief Opens Cleaned [ ] PSI Comments: ) Testin2 Comoanv: Testers Cert. Number: tJ (..{ *1 r r Westman Plumbing 31569 Nuthatch Avenue Aitkin, MN 56431 (612)-701-4789