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HomeMy WebLinkAboutRPZ Test 8/14/13 FROM CTHU> 8 15 2010 11: 051ST. 11: 28 /11o. 8001707464 P 104 • I Reduced Pressure Zone Backflow Preventer Valve & Pressure Breaker Valve • Rebuild & Ted Report _Date: Business Contact PersonfreL: • T�vrn 00-it S m1 � 1 , \ rn b-et wo 062- 2210-005¢ 46.444. 1 5 Address: City. 'Prior LU ate- I ZIP: E �a' 5372 5 tp b �r 5h •P© it RC( 'i Model: Size: 3�N �/ 1 SeriaI#: O St - g2 Make: Wii,- go, 4T Served what System: Location of Device: � 1111S ttr t2oo m install Yr.: . Rehpild Date: . ? . 609 Check Valve #2 Differential Pressure Relief Test Yr. Check Valve #1 ��( ) Closed 0( Did Not open ( ) 1 2 3 ® Leaked() Closed �� Overhauled () Opened At: t <. install (} Pressure • : •4 Pressure : 9+ ( Cleaned Cleaned E Repla etd d Replaced Replaced E tpla � Poppet P _ poppet Spring P spring Spring g A R Ring Rubber Seat Rubber Seat Rubber Seat 1- Other Repairs Other Repairs Other Repairs R s Certification thereby certify the foregoing data to be correct and that the device tested is functioning • Within the limits of the standards Dated: j Signed: COLE FORD Certifcatioa 1 066455 -I'M 1 GARY FORD Certification 0 058476 -PM 1 ALAN FARR Cerdflatioa # 066401 BF Metro Testing/ Metro Mechanical Consultants, LLC 31222 Cedar Creek Rd, Bizeldey, MN 53037 6L2- 221.5888 pig Bond License: PC646918 Mechanicel Bond Ceitifade ID: 5054 -MB This report is for the purposes of recording only; Owner is responsible for safe operation Y� • and u+k:- 1 of scheduled maintenance.