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HomeMy WebLinkAboutRPZ 8/9/2011 Page 22 of 23 ETRO TE MECHA\UCAL,LLC. E -Mail: MetroTesting.LLC @Gmail.com Visit us at: www.RPZtesting.com 1 www.MetroTesting.net Reduced Pressure Zone Backflow Preventer Valve & Pressure Vacuum Breaker Valve Rebuild / Test Report 1.2 sash ts. PVktw �savige sem*, go 171$ ` Contact Person/ Tel a "' �. r , Zatitifti Dat ' 7 171 ?AMOCO J al E1.W!Fk 952122041854 i0 (Dirutor Of Operations) ei - a© ti Address: City: Zip: 5370 WESTWOOD DRIVE PRIOR LAKE 55372 Make: WATTS 1 Model: 909QT 1 Size: 3/4 1 Serial #: 485834 Device Location: Served what System: BOILER ROOM BOILERS Install Yr: Rebuild Date: g• ao t l WA 81 2006 (Every 5 Yr. is required to be Overbauled/Rebuit, MNAdndn Rule: 4715.2161.) Test Yr. Check Valve # 1 Check Valve # 2 Differential Pressure Relief (Circle O Leaked( ) Closed ( Leaked( ) Closed (>4 Did Not Open( ) 1 2 3 4 p Overhauled ( Pressure: 0 • ( Pressure: ?- ° Opened At: .P- " R Cleaned Cleaned Cleaned E Replaced Replaced Replaced P Poppet Poppet Poppet A Spring Spring Spring I O Ring O Ring O Ring R Rubber Seat Rubber Seat Rubber Seat S Other Repairs Other Repairs Other Repairs Certification I hereby certify the foregoi • :. • :: o • - correct and that the device is tested is functioning within the limits of the standards. Signed: isi Dated: O . 7 - do r/ Tested by: GARY FORD Certification # 058476 -BF or COLE FORD Certification # 066445 -BF F i rm Name : Metro Testing/ Metro Mechanical Consultants, LLC Add r es s : 31222 Cedar Creek Rd, Hinckley, MN 55037 /v rir.41vorIiIrI rsiiiiiiVir i rA isi IiiiIvvIvIii,aPiev r Ir/V LYO////rIr/r/rPV/r/r/r /rIr. r/ r/V/ r/ rI/I/I,4 I/I///I YIr/ rte/ Ir/ rI r/ r/// rI/ O/I/ I. IV/ rI b///NA/1/rI//rIY.16y6///r//NrI. rI9 / Yr This report is for the purposes: Recording Only; Owner Ls responsible for safe operation and upkeep if scheduled maintenance. Y i /rm/rI' r r r r r r r r r r r r sv/ r/ r/ VI Ur /rsrirOrlr/r/rIV/r/ur/rOr/L0r/r r r r r r r/ r/I V ur/ r// rI r/ rer/r Yrir////I rI/I r/ ZII r/ ur. I// ////MIV/�/r//IrIVIV/rlrl� /rIrIP . l\) lc.) X t 1. A S 1A V4 hie- 7r T%S k0 " x.,40„