HomeMy WebLinkAboutRPZ TEST 8/15/2008 (2)
Sep 15 2008 12:57PM Metro Testing- Mechanical 320-384-0843
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Metro Testing
31222 Cedar Creek Road
Hinckley, MN 55037
612..221-5888
r Backflow Preventer Test Report
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Contact Person! TeL
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Owner: 1Si::>
Address: I ? ~ S?
Make:
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Location ()f Device:
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J~ City:
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Model:
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i Cheek Valve #1
Leaked( )
Closed ~_ ~
Pressure / I (?.rI T
Cleaned
Replaced
Poppet
Spring
o Ring
Rubber Seat
Other Repairs
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Size: ~"
Date: X'-/~ -0 P
Zip: ~.s; Z- Z
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Serial: 0 '7&0</
Serves what System:
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, Check Valve #2
Leaked( )
iaosed~ ~
! Pressure f, {.,;/-r
Cleaned
Replaced
Poppet
Spring
o Ring
Rubber Seat
Other Repairs
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Certification
I hereby certify the foregoing data to be corre~d ~.a.! tlte_ de.vAce tested is functioning
Within the limits of the standards signed: ~\ ~
Firm Name: Metro Testine: 31222 Cedar Creek Rd. Hiocldev. MN 55037
Tested By: Gary Ford Certification # 0S8476-BF OR Cole Ford Certification # 6644S-BT
This report is for the purposeslRecording only; Owner is responsible for safe 1J.t'",~.:Jion
And upkeep of scheduled maintenance.