HomeMy WebLinkAboutBackflow Preventer Report 4/13/2007
HEATING. AIR CONDITIONING
TEMPERATURE CONTROL. PLUMBING
CERTIFICATION - I hereby certify the foregoing data to be correct and that the tested
device is functioning within the limits of the standards.
By: ~ ~ Tester Certification # 00505T Phone # 763-784-8178
DON PYL
NEXT OVERHAUL
04/0/2008
Comments: 4TH YEAR TEST
04/13/2007
Check Valve #1 Check Valve #2 Press. Oif. Press. Dif. Strainer
Across #1 When Relief
Check
Test Before Leaked [ ] Leaked [ ] 10,0 5.0 None rJ
Repairs Closed [x] Closed [x]
Final Test Closed [x] Closed [x ] 10.0 5.0
Device Location:
LOWER LEVEL BOILER ROOM TO THE UPPER LEFT OF THE BOILER
Device Serves What System:
BOILER MAKE UP WATER
Occupant: WELLS FARGO Phone Test Date:
612-667-2984 4/13/07
Device Make and Model: Size: Serial #:
WATTS 009 QT lh" 210214
Zip:
Site Address: 16817 DULUTH AVENUE SE, PRIOR LAKE, MN
I Job #25821
BOILER SERVICES, INc.
10327 Flanders Street NE
Blaine, MN 55449-5711
763-784-8178
BACKFLOW PREVENTER TEST REPORT
BACKFLOW PREVENTER TEST REPORT
BOILER SERVICES, INC.
10327 Flanders Street NE
Blaine, MN 55449-5711
763-784-8178
I Job #25821
Site Address: 16817 DULUTH AVENUE SE, PRIOR LAKE, MN
Zip:
Occupant: WELLS FARGO Phone Test Date:
612-667-2984 4/13/07
Device Make and Model: Size: Serial #:
WATTS 009 QT ~" 210203
Device Location:
LOWER LEVEL BOILER ROOM
Device Serves What System:
NOT IN USE. NOTHING IS CONNECTED TO IT.
Check Valve #1 Check Valve #2 Press. Dif. Press. Dif. Strainer
Across #1 When Relief
Check
Test Before Leaked [ ] Leaked [ ] None ~
Repairs Closed [x ] Closed [x]
Final Test Closed [x] Closed [x ]
Comments: LAST TIME THIS RPZ WAS TESTED
02/04/2003
CERTIFICATION - I hereby certify the foregoing data to be correct and that the tested
device is functioning within the limits of the standards.
By: OM lj:La Tester Certification # 00505T Phone # 763-784-8178
DON PYL S
HEATING. AIR CONDITIONING
TEMPERATURE CONTROL · PLUMBING