HomeMy WebLinkAboutRPZ TEST 8/14/2008
Sep 15 2008 1:01PM
Metro Testin~- Mechanical 320-384-0843
p. 10
Metro Testing
31222 Cedar Creek Road
Hinckley, MN 55037
612-221-5888
Backflow Preventer Test Report
E~ ~)&<JJ) t__
Owaer: J: Si) Contaet Person! Tel.
Address: c ,.( ~[;~.) ....... -- City: 0 /
:/ 3D '-f t:a . ~~~/...J:.l...A) 1> l ~ r /~ I 0 K. LJ4 k~
Make:, ) Model: 9 q. - Size: 3 ~/"
~~~~ 01 QI ~
Date: p- (c.(-$
Zip:
:S>3'7~
Serial:
vJ bO? '8(:-/)
Location of Device:
\So,1a... ~ m
Serves what System:
~1kJ?
.
Test Year
C~'f
R
E
p
A
I
R
S
-I- Check Valve #1
Leaked( )
: Closed ~ "\7
I Pressure o. 5
I
Cleaned
Replaced
Poppet
Spring
o Ring
Rubber Seat
Other Repairs
I Check Valve #2
I Leakecl( )
I Closed ~ \.7
Pressure ~ . l
Cleaned
Replaced
Poppet
Spring
o Ring
Rubber Seat
Other Repairs
DitT.....",,_tial Pres. Relief
Did Not Open
Opened At 5,8
Cleaned
Replaced
Diaphragm
Spring
o Ring
Rubber seat
Other Repairs
Ii Certification
I I hereby certify the foregoing data to be correct and that th~ devj~e tested is functioning
I Within the limits of the standards signed: ~ ~
!
- Firm Name: Metro Testine: 31222 Cedar Creek Rd. Hincldev. MN 55037
Tested By: Gary Ford Certifieation # 058476-BF OR Cole Ford Certification ## 6644S-BT
I_ThiS report. is for the purposeslRecording only; Owner is responsible for safe operation
And upkeep of scheduled maintenance.