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HomeMy WebLinkAboutRPZ 8/4/2011 Page 12 of 23 FIR TESTIN G OM ECHA ,ICAL 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 1.3 Business: Nor Lad*. Siiltagek ; $ 749 Contact Person/ Tel: JA11411106FtbiditelANSWILMMILUIII 1?atet' `! ; JEFFERS POD ELESSITMY JIM MUM $52 12284054 Off Praetor Of (*rations) Address: City: Zip: 14800 JEFFERS PASS NW. PRIOR LAKE 55372 Make: WATTS I Model: 00912 [ size: 1 I Serial #: Mt 164 Device Location: Served what System: BOILER ROOM BOILERS Install Yr: Rebuild Date: ` ' Ao f f N/A (Every 3" W la required to be Overharrled/Rebuil4 MNAdmin Rule: 4715.2161.) Test Yr. Check Valve # 1 Check Valve # 2 Differential Pressure Relief (Circle One) Leaked( ) Closed 66 Leaked( ) Closed () Did Not Open( ) 1 2 3 4 Overhauled (u) Pressure: Pressure: � ` t Opened At: / Cleaned Cleaned Cleaned Replaced Replaced Replaced Poppet Poppet Poppet A I Spring Spring Spring 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. y Signed: •• Dated: 7- L' c° /1 Test ed 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 VAIV /PY / / / / / / / / / / /IYr�/ /Y /IYO /eY / / / / / .. ,.NA,A,NAI /.U..,.I/.YOV /.0,I /.ry %,7411411711/Y /41 /4/4.Y.R�,o,O/IYO,MA..s,// / I. I.. y. YI/. WAI, V. 4. .�LY/..VIY.d//INI,.N//I%//.Y!/4 $$ This report is for the purposes: Recording Only; Owner is responsible for safe operation and upkeep if scheduled maintenance. / / / / / / / / / / / //a VAIVIZIA® is 41WAr /srs /,r7BY ®/AMOYAMor/s / ®u�r /was /s /sMav / / / / / //II /IPASSO ATIVIYAMI /O" ®4spl/s/s�///MMAIVIiANI Irlv.MM PYIPWi wM 1106712011 Page 13 ot 23 METRO TESTIN G', MECi-IANICAL_ LLC E -Mail: MetroTesting.LLCaGmail.com Visit us at: www.RPZtesting.com 1 www.MetroTesting.net Reduced Pressure Zone Backflow Preventer Valve & Pressure Vacuum Breaker Valve Rebuild / Test Report 2.3 moms; Prk* Savage Still* I # 719 Contact Person/ Imam Date: i ' ANUS Ply ELEMME$T Qp 2 ao " r Address: City: Zip: 14800 JEFFERS PASS NW PRIOR LAKE 55372 Make: AMES [ Model: 2000 B I Size: % I Serial #: 37 716 Device Location: Served what System: BOILER ROOM FIRE SYSTEM Install Yr: Rebuild Date: $ - btol NIA (Every S" 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 ( )6 ' 'd Not Open( ) 1 2 3 4 Overhauled (Y.) Pressure: ° • O ` V r. r Pressure: a • O .1- 1 1 %r _ Open t: R Cleaned Cleaned Cleaned E Replaced Replaced Replaced Poppet Poppet Poppet A Spring Spring Spring I O Ring O Ring O g R Rubber Seat Rubber Seat R • ber Seat S Other Repairs Other Repairs 1 er Repairs Certification I hereby certify the foregoin // be correct and that the device is tested is functioning within the limits of the standards. Signed: . N � Dated: a`© Tested 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, Rincldey, MN 55037 ; This report is for the purposes: Recording Only; Owner is responsible for safe operation and upkeep if scheduled maintenance. 7iw��ws�s�s��jr� / / �I/ e► �r�. r�w�® �s�® i®® uu�s/ r�s�md�w�si® �su�lisio��ir �s���// ��®. rys�s�sis�ws�® �s�s�. HeuLr�s��iiiwisi�ioi��. iuuvl// ®y�//.NS�Oi.N��si�Y//��ii�c�r// iw vmii I'ae c 14 of 23 TIN ETR OTESMECNANICAL 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 3.3 Busies: PMigl'r OD # 718 Contact Peraoni Tel: 1 k12 Date: AN= aig1139TARY JIM DELLWEk 952/ 229.0054 j (Director (X Operations) oce, it Address: City: Zip: 14800 JEFFERS PASS NW PRIOR LAKE 55372 Make: APES 1 Model: 3000 SS 1 Size: 4 1 serial #: 146 494 1005 Device Location: Served what System: BOILER ROOM FIRE SYSTEM Install Yr: Rebuild Date: T — R 011 N/A (Every 5 6 Yr. is required to be Overhauled/Rebully MNAdmin Rule: 4715.2161.) Test Yr. Check Valve # 1 Check Valve # 2 • ifferential Pressure Relief (Circle One) Leaked( ) Closed ([) Leaked( ) Closed (A) ►; d Not Open( ) 1 2 3 4 Overhauled (x) Pressure: 2. 0 -77 •T Pressure: .2. 017114.T Opened A. R - Cleaned Cleaned Cleaned E Replaced Replaced Replaced P Poppet Poppet Poppet A Spring Spring Spring 1 O Ring O Ring O Ri R Rubber Seat Rubber Seat Ru. . er Seat S Other Repairs Other Repairs Other Repairs Certification I hereby certify the foregoin data correct and that the device is tested is functioning within the limits of the standards. Signed: "" Dated: 7')o t l Test e d 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 iiiiiiia /sisiwiiaIW/4113%i47/4r/ ii�si ®i1//4,/ si�riiui / i / / i4ii.0ii ' i iii / / i i / / iiri/0/7•WWriiriiiiriii iiii r5115107%iirIV��imwiiivirwwiiiIriiii $ This report is for the purposes: Recording Only; Owner is responsible for safe operation and upkeep if scheduled maintenance i.►i s/A Pi®/ siwisi. iiwVsi.. i∎ 4sui.►i si di® isiriei. efr4ICOi.rioi®i,VYsinieis 9ie7oi si• s/ ri/ sarismiw / ®isisiAiviri+isiruiii0i sisimisisisiIMsisisisisiiieiii/ iuisii /siuoi alisilf. Sri 7/2011