HomeMy WebLinkAboutRPZ TEST 8/14/2008 (2)
Sep 15 2008 12:58PM Metro Testing- Mechanical 320-384-0843
p.5
Metro Testing
31222 Cedar Creek Road
Hinckley, MN 55037
612-221-5888
n Backflow Preventer Test Report
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Contact Person! Tel
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Owner: r-:-- i'-... i
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I Address:-- . ~- ':'"') City::J Ik
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Make: fA If't''S Model: ~ 199 ) Size: --W..
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Location of Device: Serves wbat System:
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Test Year
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Date: Q I 'V
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Zip:
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Serial: cJo5 n2
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Cbeck Valve #1
I' Leaked( )
Closed ~
I
! Pressure
i Cleaned
Replaced
Poppet
Spring
o Ring
Rubber Seat
Other Repairs
I Cheek Valve #2
Leaked( )
Closed (64-
Pressure
-..-----.-....
Differential Pres. Relief
Did Not Open
7.2-
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Opened At "3. 6
Cleaned
Replaced
Diaphragm
Spring
o Ring
Rubber seat
I Other Repairs
Cleaned
Replaced
Poppet
Spring
o Ring
Rubber Seat
Other Repain
-
Certification
I hereby certify the foregoing data to be correct and th~t the ~evice 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
This report is for the purposeslRecording only; Owner is responsible for safe operation
And upkeep of scheduled maintenance.