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HomeMy WebLinkAboutRPZ TEST (2) TEST AND MAINTENANCE REPORT FORM RPZ - Reduced Pressure Zone Assembly - RPZ 3304 GLEN WATER TRAIL, PRIOR LAKE GLEN WATER WEST Date: WILK Model 975XL Serial# 1063061 Address: Owner: Make Size 2 INITIAL TEST OF DEVICE: Check Valve #1 Leaked [ ] Closed t-t Pres. Dif #1 Check: tr_ 1-[ PSI Pres Dif Relief Opens ),_ I...- PSI Strainer: None [.4:-- Cleaned [ ] I Check Valve #2 Leaked [ 1 Closed .f.+ PSI ~- r I MAINTENANCE OF DEVICE: Check Valve #1 Check Valve #2 Cleaned: Cleaned: Repaired: Repaired: CHANGED OR NE:W DEVICE INSTALLED: Date: I I --- Device Type: Model: Manufacturer: Serial No.: Size: FINAL TEST: Check Valve #1 Pres. Dif#1 Checl\:: Strainer: None Lxi. Leaked [ ) Closed P<I f0 ~7 PSI Pres Dif Relief Opens Cleaned [ ] Jv v' PSI Comments: / j Ii'.,-- !0V Testine Company: Testers Cert. Number: 0 t.{, q J r' Westman Plumbing 31569 Nuthatch Avenue Aitkin, MN 56431 (612)-701-4789