HomeMy WebLinkAboutRPZ Test Report 2011 15:19 7635193932 PAGE
ROTO ■ _OOTER PLUMBING SERVICES CO w
BACK.FLOWV PREVENTION (RPZ) TEST REPORT
14530 27th Avenue N.
Plymouth; MN 55447 •
763 - 559 -3522
ne r -s „. Ager ,4: x .w.. Device 1 cAtior, i. _.r./ -' .dked
kdress ___ S'T {' .: ;:'C.r W - - System !so1ated ZW6.4 -
I nstall Dante_
ate ,. �'_
-
:t Person ^ _,t ,,G: Overhaul mate y il Ir
Number Test Date ., `( ,2.'1 ,,, 1 -..
FA5,sembly: RPZ DCV ❑ .
//
�,�_,,�
_fa' 7 ... Model _a W Serial Number, /t ?. Size f
eplacement it applicable:
Model Serial Number Size
IECK VALVE #Z RELIEF VALVE — CHECK VALVE #2 CHECK VALVE #2
BACK PRESSURE CONFIRMATfON
[-,.= Leaked --- Leaked
raked Opened at: —•-�- psi
lased tight Did not open Closed tight tight
❑ . - -• - - ..- - - Differential-pressure...- - - --- K'Closect
erential- pressure� --- -- •-
_ Ps i . !�P I ..A7/ V psi
eeaed only. El Cleaned only ❑ Cleaned only
eod: Replaced: Replaced:
Rubber kit n Rubber kit ❑ Rubber kit
CV assembly ❑ RV -a embty ❑ CV assembly
or disc or disc or disc
0-rings ❑ o -rings ❑ O - rings
Seat ❑ Seat ❑ Sept
Spring ❑ Spring ❑ Sprin
Stern/Guide ❑ Diaphragrn(s) • ❑. Stem/Guide
Other, specify ❑ Other, specify' ❑ Other, specify.'
Other. specify, ❑ Other, specify: ❑ Other, specify. '
esk aft er repairs: Opened at: Final test: Final test: