HomeMy WebLinkAboutRPZ 3/10/2011 1'acc 21 or 23
ETR OM �' ,
1cA� 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
2.2
Bi i t t � CeaitactFer Fla . f
"t' ikat i . DELL* 1-■ fQ • I/
Address: City: Zip:
15860 FISH POINT ROAD SE. PRIOR LAKE 55372
Make: WATTS Model: 909 QT I Size: % 1 Serial #: 405 882 Device Location: Served what System:
BOILER ROOM BOILERS
Install Yr: Rebuild Date:
NIA 81 3 2009
(Every 3 Yr. is required to be Overhauled/Rebuilt, MNAdmIn Rule: 4715.2161.)
Test Yr. Check Valve # 1 Check Valve # 2 Differential Pressure Relief
(Circle one) Leaked( ) Closed (-&) Leaked( ) Closed (J) Did Not Open( )
02 3 4
Overhauled ( ) Pressure: r?' a Pressure: 6' S Opened At: "
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 / data correct and that the device is tested is functioning within the limits of the standards.
Si .'''C 3.10 -a,0 11
Signed: Dated:
T e s t ed by : GARY FORD Certification # 058476 -BF or COLE FORD Certification # 066445 -BF
F i rm N a me : Metro Testing/ Metro Mechanical Consultants, LLC Add r es s : 31222 Cedar Creek Rd, Hinckley, MN 55037
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/ � This report is f or the purposes: Recordin Onl Owner is responsible for sa operation and upkeep i scheduled maintenan 1
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Page 20 of 23
,
M ETROTTE s cTANICAL,LLC,
E -Mail: MetroTesting.LLC @Gmail.com
Visit us at: www.RPZtesting.com I www.MetroTesting.net
Reduced Pressure Zone Backflow Preventer Valve & Pressure Vacuum Breaker Valve ,
Rebuild / Test Report X.
1.2
�t4isitiewialior . ' e Sdials, is) S TiS Contact gerstmJ r' ; f --,-, :. --
Ivistitints ' JIMOSLWIk ll fnses4 - -.
( Of } `c - � ,'to(i
Address: City: Zip:
15860 FISH POINT ROAD SE. PRIOR LAKE 55372
Make: WAITS Model: 957 I Size: 3 I Serial #: DIN 0303
Device Location: Served what System:
WATER METER FOR IRRIGATION IRRIGATION
Install Yr: Rebuild Date:
NIA 513 2011
(Every ? Yr. is required to be Overhauled/Rebuilt, MN Admire Rule: 4715.2161.)
Test Yr. Check Valve # 1 ' Check Valve # 2 Differential Pressure Relief
mrdeono Leaked( ) Closed ( V) Leaked( ) Closed (X) Did Not Open( )
1 2 3 4
Overhauled (X Pressure: Pressure: Opened At: .
R Cleaned Cleaned Cleaned
E
Replaced ac ,
ep ' ep 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 foregoing data be correct and that the device is tested is functioning within the limits of the standards.
Signed: 0 Dated: 3 , PO !/
Test ed by : GARY FORD Certification # 058476 -BF or COLE FORD Certification # 066445 -BF
F i rm Name: Metro Testing/ Metro Mechanical Consultants, LLC Address : 31222 Cedar Creek Rd, Hinckley, MN 55037
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This report is for the purposes: Recording Only; Owner is responsible for safe operation and upkeep f scheduled maintenance.
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