HomeMy WebLinkAboutRPZ 8/14/2008
Sep 15 2008 1:00PM
Metro Testin~- Mechanical 320-384-0843
p.s
Metro Testing
31222 Cedar Creek Road
Hinckley, MN 55037
612-221-5888
/ Backflow Preventer Test Report
( ~/:njt.JCX:JJ)
Owner: .:IS.D 7,/ Contact Person! Tel.
Add City'
ress: 506/ "1,,.JrJE<;.oTA bl Sc .
Make: r \ Model:
(,...IJi ~ cx::/j M~
Location of Device:
!<S" /a ~)m
Ted Year
/ I rJJ.
'--! (t.
R
E
P
A
I
R
S
Date:;p'_ fJI.-&
Zip: 5~ S?Z
Serial:
J / ?'1i?1
~,O~ LAk.
Size: ~/.,
/4
Serves what System:
~,I~
Ch<<k Valve #1
Leaked( )
Closed (oJ r-<::;;:? '"'\")
Pressure tJ . cf
Cleaned
Replaced
Poppet
Spring
o Ring
Rubber Seat
Other Repairs
Check Valve #2
Leaked{ )
Closed ~
Pressure
Diff:.;, , ~d,tiaI Pres. Relief
Did Not Open
Opened At L(!
Cleaned
Replued
Diaphragm
Spring
o Ring
Rubber seat
Other Repairs
?6
Cleaned
Replaced
Poppet
Spring
DRing
Rubber Seat
Other Repairs
Certification
I hereby certify the foregoing data to be correct and that the device tested is functioning
Within the limits of the standards signed:
Firm Name: Metro Testinl 31222 Cedar Creek Rd. Hincklev. MN 55037.
Tested By: Gary Ford Certification ## 058476-BF OR Cole Ford Certification # 66445-BT
I This report is for the purposes/Recording only; Owner is responsibiefor safe \"'l'".."tion
And upkeep of scheduled maintenance.