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RPZ 7/13/2011
Page 9 ot 23 ETRO TEST IECI•-IANICAL LLC. E -Mail: MetroTesting.LLCa)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 Busing= P .. Kenn . Contact Person/ Tel: i :" "" U P,I3afe•r- - -; MOW OAS 001' Jai DEIVa tat t‘0054 Pector Of Address: City: Zip: 15855 FISH POINT ROAD SE PRIOR LAKE 55372 Make: WATTS I Model: 009 DC ! size: 3 f serial #: 09 804 Device Location: 1 Served what System: IRRIGATION HOUSE BACK SIDE OF SCHOOL IRRIGATION Install Yr: Rebuild Date: WA 81 2007 (Every 5 a Yr. is requdred to be Overhauled/Rebuilt, MNAd in Rule: 4715.2161.) Test Yr. Check Valve # 1 Check Valve # 2 D ifferential Pressure llief (Circle One) Leaked( ) Closed Cy.) Leaked( ) Closed (V ) I ' Not Open( ) 1 2 3 Cy Overhauled ( ) Pressure: ` 1 Pressure: (� c/ h 1 Opened A 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 Rubbe eat S Other Repairs Other Repairs • , ' Repairs / Certification I hereby certify the foregoing to be correct and that the device is tested is functioning within the limits of the standards. Signed: PA Dated: 7 l ° � 0 11 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, Hinckley, MN 55037 ' /ir pie/ iisiiriirrsrrrrir �r/ iiwiiir/ r/ irrir/ riririsiriiio/ r/ O/////r/// r/ O/ O/ r/ O/r/// r/ I/ S/ I/// r/ r/ I/ r/r/ r/////// YY//// r///r///!/r// 6r//! r/// r/r /I7I/r///r /N / /I8lY/Yr /r/IVr /I /Q This report i s for the purposes: Recordin Onl Owner is responsible for safe operation and upkeep if scheduled maintenance, j A/ r// /r/r/i/~/r ///r/d /r /r /r /s / / /•/r/ / / / / / /.// r/ r/ r/ r/ r/ r/®/.®/ r/ r/®/ d/.®/r/ r/®/ r/ r/ r/ r/ r/®/ r/ r/ r/ r/ O/ r///// r/r/r/ O/ r/ I7r/®/ r/// r/// r/ r/ r/A 0 /r/.dr ///r/r///r///I/r///O/O/rr 4- '!/2611 1'a 10 ut 23 ETR M TESTIN G MECHANICAL 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 2.3 swi Pr'kl[ tchools, 10 # 718 Contact Person/ Tel: k1Z. .Ut Date: woo OAKS Wzg.E JIM DELLW 9521: Of d) 7. ; ©l( Address: City: Zip: 15855 FISH POINT ROAD SE PRIOR LAKE 55372 Make: WATTS Model: 909 QT I Size: s/4 1 Serial #: 428 809 Device Location: Served what System: PENTHOUSE BOILER ROOM BOILERS Install Yr: Rebuild Date: NIA 8/ 2006 (Every 5 Yr. is required to be Overhauled/Rebulll, MN Admix Rule: 4715.2161.) Test Yr. Check Valve # 1 Check Valve # 2 Differential Pressure Relief touch one) Leaked( ) Closed ( </,) Leaked( ) Closed ( Did Not Open( ) 1 2 3 4 Overhauled (') Pressure: (2 /. 2 Pressure: . F. 1 Opened At: .0 R Cleaned Cleaned Cleaned Replaced Replaced Replaced 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 to be correct and that the device is tested is functioning within the limits of the standards. Signed: ( Dated: 1 ` Tested by : GARY FORD Certification # 058476 -BF or COLE FORD Certification # 066445 -BF F i r m Name : Metro Testing/ Metro Mechanical Consultants, LLC Address : 31222 Cedar Creek Rd, Hinckley, MN 55037 7 ,..00/4// ,/a //7..,Wa, OVA,. UP /5/4....10..ry�40.4,IP/v,//0. / 070. 4F. O7S. 4. OYIP ..U.VO.I.O.A.I.I..U.yIP.P.A.O. ///.I/ O/// A.////,.. //...//4..Y.UO.....Y.y.U//.NIOY.Y AIWAVISSV.O%/O..b//�I AV This report is for the purposes: Recording Only; Owner is responsible for safe operation and upkeep if scheduled maintenance. $ / 0/ O. su/// A. 0�0/ 0. 0/ O. O/ O. O/ O/ O/ 0/ A/ 0/ O/ O/ 0. 0 /O /su /O /OG/ /O/O /O/O/A/O/0/O/A/s /0/0.0.0. OHO. O. O. OLY/ Y/ O/ OrA/ 0. 0. 0. 0. 0/o i~/~ /0 /Ai0�0iA.s /.v.I/.I/O/Oie/ / / / / ous///O.O.OrA w. vmu Page 11 of 23 . M hummilimmi E 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 3.3 Business:, Prior rior E anntair Siawds, ISD * 118 ` Contact Person/ Tel: k11Zlflfus -- Date: i OAKS INNME al DELI .WO:9521 . (Muter Of Operations) 7- f -ac1< Address: City: Zip: 15855 FISH POINT ROAD SE PRIOR LAKE 55372 Make: WILKIN3 Model: 975XL I Size: 1n I Serial #: 128 8938 Device Location: Served what System: BOILER ROOM BOILERS Install Yr: Rebuild Date: N/A 81 2006 (Every 5 Yr. is required to be Overkau/ed/RebaiIt MNAdmin Rule: 4715.2161.) Test Yr. Check Valve # 1 Check Valve # 2 Differential Pressure Relief (Circle One) Leaked( ) Closed (50 Leaked( ) Closed ( Did Not Open( ) 1 2 3 4 Overhauled ( • Pressure: 1 • 2 Pressure: V • c f Opened At: 3.3 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 foregoin data be correct and that the device is tested is functionin �within the limits of the standards. Signed: h ( ` Dated: - 13 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, Hinckley, MN 55037 / / / / / / ///O.//,, /..I/ / / / / / ... /./.// / / / / / / / / / / / / / , // . 4. I. oNI. IYO.//O//. I.// ar//. //IYI///AG�2.4/.A.I�/////../Y/// YAP//// lIY/ 6 ///Y////IY ///['//I6' /NCIYIY//.[ $ This report is for the purposes: Recording Only; Owner is responsible for safe operation and upkeep if scheduled maintenance j t / 4 ' YF/ / / . / / / . / / / ..a7oisi®ii /sisisio41/41M i4/iriiiIIMI/O MIMI /4/i /io /e /.was /4/i ®is /417. ~ 1114/ i /i®i4/i.1111.rrsiiii PYdr/Iioii►ii/ 0141,/ si /i. 111111 /iiiasiIFrlsair/i4v/MIAIK A Rev Mall