HomeMy WebLinkAboutRPZ TEST 8/30/2010 FRQM fTUE� 2 S 2611 ♦2:2418T.12:27JNo.800173T389 P 8
N.[etro '�'esting
31222 Cedar Creek Road
� Hinckley, M� 5�037
612-221.-5$88
—�~ Backflow Preventer Test Iteport
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Ow�er: ,,,..,. Cantact Pexson/ Tel. Date:
..1s.5 � �!� $' '�►t3' t ()
Address: Zi
City: p:
f�'�t� �F�� ��� a � ��, a� �. �,��..
Make: Model: Size: .� Seri�►1:
ZJ�►�z �ca°�,��. � �4 r� r t b�
Loe�tia� of Device: Serves what System:
t �hi,�.$� �t�� �j,�,':T.a(��T�r�ra
Te�t Year Check Valve #1 Check Valve #2 Differenti�.l Pres. Relief
�� Leaked{ ) Leaked( ) Did Not Open
� f .-- � Closed �L�„ Closed (�}
`�' Pressure ��� Pressure � • � Q ened At •�_ �
Cleaned Cleaned Cleaned
� Repl�ced Replaced Replaced
poppet Poppet Dia.phr�tgm
� Spring Spring Spring
p o �� o ��g o ���
� Rubber Seat Rubber Seat Rrabber seat
Other Repafrs t�t�er �,2.epairs Other Repairs
�
R
S
Certifca�Eion
I hereby certi�y the £oregoivag data to be carrect suc�{�t a.t t.�e 'ce t d is functioning
Withut the limits af t�e standards signed: `�� c
I+'irm Name: Metra Testin� 31222 Cedar Creek Rd. Hincklev. SS037
Tested By: Gary Ford Certification # 058476-BF OR Cnle Fard Cer#i�catinn # 6C►44S-BT
' This report is for the purposeslRecording anly; Owner is respansibie £or safe operation
And u kee af schcduled maintenance.
FROM CTUE) 2 8 20Y1 72:241ST_�2:21fNo.$00�73T3B3 P 9
Metro Testing
31222 Cedar Creek Road
Hinci�ley, MN 55037
f 12-221-585�
,,,,...�--- IIackflow Prevez�ter Test Report
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Ownter: � �� Contact Person/ Tel. l)ate: �. ,,; �^ t �
Address: City: Zip:
!'�180U f.�'��5 s� r��-� r�Ez. j� r d�
Make: Model: Size: r� " Serial:
,�1�a�s �.�� � 3 ��Ib
Location of Device . Serves �vhat System
�� �rr�. S t°b
' Test Year Check Valve #1 Check Valve #2 Differential Pres. Relief
T � E Lcaked( ) Leaked( ) id Not Upen
,� J ,.,, Closed �. W ,.�' ,,, Closed (o� �,,.--+ „�
��� � pressure t`� "� � Pre�s�re t'�� � Cl e d At
Cleaned Cle�ned eaned
R Replaced Replaced R lace
kappet Poppet Ui� h gm
E Spriung Spring Spri
p O Ring O Ring O'
A Rubber Seat • Rubber Seat , Ru ber at
4ther Repairs Other Repairs Uther pairs
�
�.
�
Certificat�c�n
I hereby Ce�rt�:f� the faregaing da#a ta be correct, �nd that the devic+e tested �s funct3oning
Within the limits af the standards signed: �� �.='�'�„-_....._„�
Fiarm �Tame: esti 3122 eda e R. Hinc MN S 037
Tested By: Gary Ford Certificatian # OS8476-BF OR Cole Ford Certification # 66445-BT
This report is for the purposes/Recording only; Qwner is responsible �for safe o�eration
And u kee of scheduled maintenance.
FROM CTV6T 2 8 20Y1 12:2415T.�2:21lNo.800173T369 P 70
Metro Testing
31222 Cedar Creek Road
�Iinckley, MN 55037
612-221-5888 �
k3ackflc�w Preventer Test Report
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Ownert Cont ct Person/ Tel. Date: �' � 0« ��
�� e
Aadx�s�: •
'�� �irr' �+4�5 ra� � t2►�#�, � Zip.
Make: Mode1: Size: r Sex`ial: "�-!
l�a?F�► �C� 'S� � 1� W J`l �O(�
Loca#ion of Device: Serves what System:
l�r ��i� .�� i3�r � '�,�N�
Test Year Check Valve #1 Check Vaive #2 'ffereutial Pres. Re '
.�� Leaked( ) Leaked( ) Di ot Open �
�,� Closed (� � Closed � �,,-'° �
� �s
r''
Pressure �+�,,,�.� Pressure ����� Q �ne A
, Cleaned Cleaned Cle ed �
R R��f1aECCCI Re�'11AC�(� R 1 f�(�
Poppet Foppe� aph gm
� Spring Spring pring
p o Ring a Rimg rting
A Rnbber Seat Rubber Seat ubber s#
Other Repairs Other Repairs 4ther epairs
�
R
S �
Certif cation .
I hereby certify the faregoing data to be correct a�l that tbe device tested is fe�nctioning
Wit�ia tbe �imits o�'the �tandards si�gned: �rati. -��-2.�
Firm Name: Metro Te.qtin� 31222 Cedar Creek Rd. Hincklev, 55037
Tested By: Gary Furd Certi�catian # Q584'7G-BF 4R Cole �'�nrd Certa�ca#ion # 66445-8'T
This report is for the purposes/Recordir�� only; Owner is responsible for safe operation
And u kee of scheduled maintenance.