HomeMy WebLinkAboutRPZ TEST 8/15/2008
Sep 15 2008 12:57PM Metro Testing- Mechanical 320-384-0843
p.4
Metro Testing
31222 Cedar Creek Road
Hinckley, MN 55037
612-221-5888
Backflow Preventer Test Report
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Contact Penon! Tel.
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Owner:
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Address: /
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Make: tJA~ Model: CJ 0 I QT
L~tion of Device:
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Test Year
2~L
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City: ::=.2
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Size: 3./c.f .,
Date: "? - (5-0?
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Serial:
(..17.. 7J cg 0 I
Serves what System:
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Cheek Valve ##1
Leaked( )
Closed bd "''7, I r
Pressure "'i
Cleaned
Replaced
Poppet
Spring
o Ring
Rubber Seat
Other Repairs
Check Valve #2 ~.",,-'~'" '1
Leaked( )
Close~ Q r
Pressure G::> . \
Cleaned
Replaced
Poppet
Spring
o Ring
Rubber Seat
Other Repairs
.. Differential Pres. Relief
Did Not Open
Opened ~t.3 ' (. .
Cleaned
Replaced
Diaphragm
Spring
o Ring
Rubber seat
Other Repairs
... ....,
I
i Certification
! I hereby certify the foregoing data to be corree~~~ ~he 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 CertifialnOD # 66445-BT
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U This report is for the purposeslRecordmg only; Owner is responsible for safe operation
And upkeep of scheduled maintenance.