HomeMy WebLinkAboutRPZ TEST 8/14/2008
Sep 15 2008 1:00PM
Metro Testing- Mechanical 320-384-0843
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Owner:.-.-- T"'> I Contact Personl Tel.
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Address: City:
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Make: UlAn> Model: crOCj Q T
Location of Device:
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Metro Testing
31222 Cedar Creek Road
Hinckley, MN 55037
612-221-5888
Backflow Preventer Test Report
Date: ~ Ic(-a?!
Zip:S5 !?Z
Serial: C/ / /L(K t/
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Size: 3 / ..
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Serves what System:
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Test Year Cheek Vah..e #1 Check Valve #2 Differen tial Pres. Relief
Leaked( ) Leaked( ) Did Not Open
Z~~( Closed.~ ~.{ Closed tl (.~ Opened At ~. J
Pressure Pressure
( Cleaned Cleaned Cleaned
- -
R _ Replaced Replaced _ Replaced
_ Poppet _ Poppet _ Diaphragm
E _Spring Spring _ Spring
p _ 0 Ring o Ring _ 0 Ring
A - Rubber Seat Rubber Seat - Rubber seat
Other Repairs Other Repairs Other Repairs
I
R
S
Certification
I hereby certify t.e foregoing data to be correct
WithiD the limits of the standards signed:
that the dev. tested is functioning
Firm Name: Metro Testinll 31222 Cedar Creek Rd. Hincklev. MN 55037
Tested By: Gary Ford Certification # 058476-BF OR Cole Ford Certification # 66445-BT
This report is for the purposeslRecording only; Owner is responsible for safe operation
And u kee of scheduled maintenance.