HomeMy WebLinkAboutRPZ TEST 8/14/2008
Sep 15 2008 12:5SPM Metro Testin~- Mechanical 320-384-0843
p.S
Metro Testing
31222 Cedar Creek Road
Hinckley, MN 55037
612-221-5888
(titifl Backflow Preventer ~est ~~P<>:_
Contact Penon I Tel.
~ (}..~~ ~DJlL
Owner: _ f"') ~
..L s ;-';> " I
Address: /" Cit)':
JS~ i.,-r{ ~lSl ~')~.
Mak~:u v)A~ Model: <75 ?
Location of Device:
nT~lDC. I~ ~roYl "i11'2.kLi~ "17- j"
Test Year
I /1J;J
1 f-
R
E
p
A
I
R
S
-. . --
Date: 0- rc{-()o
Zip: S ~ ,) c..
n ..2
s~e: =--S~\_. Serial: f) K - D ~6 "3
Serves what System:
. -r;..."t..,C::>A "eJ
t~loiL~~
. Cheek Valve #1
Leaked( )
Closed ~
Pressure
Cleaned
Replaced
Poppet
Spring
o Ring
Rubber Seat
Other Repairs
-. .-------
Ch~k Valve #2
Leaked( )
Closed ~
. Pressure
Cleaned
Replaced
Poppet
Spring
o Ring
Rubber Seat
Other Repairs
Opened At
Cleaned
Replaced
Diaphragm
Spring
o Ring
Rubber seat
Other Repairs
Differential Pres. Relief
Did Not Open
Certification
I hereby certify the foregoing data to be correct and that the device tested is funetioning
Within the limits of the standards signed: ~ ~d...s-
Firm Name: Metro Testintl 31222 Cedar Creek Rd. Hincklev. MN 55037
Tested By: Gary Ford CertulC8tioD # 058476-8F OR Cole Ford Certification # 66445-BT
I This report is for the purposes/Recording only; Owner is responsible for safe oJX;..uLon
And upkeep of scheduled maintenance.