HomeMy WebLinkAboutRPZ Test 8.14.13 FROM
• (TRW 8 10 2013 11 : 3 3 /ST.11: 28 /No.8001737484 P DAD
TESTING
MECHANICAL •
Reduced Pressure Zone Backflovv Preventer Valve & Pressure Breaker Valve '
Rebuild & Test Report
- P lot (cLI L
Business; Contact Person /Tel.: Date:
eWcC . Jim be(f G z2to-CO J4 13
Address: City: ..._
5 4- WFs\ 4XXrJ Sb. ri dP ) ri or (ate ; 5372
Make: Size: #:
1tV Model:
(3 / 09 CST 4-� I Serial
IN C9 2VOI .
Location of Device: Served what System:
1(v taf Zoom 1' of (12/S
Install Yr.: • Rebuild Date:
Test Yr. Check Valve #1 Check Valve #2 ' Differential Pressure Relief
1 () 3 4 Leaked() Closed (XI Leaked() Closed (X) . Did Not Open ( )
Overhauled ( )
Install () Pressure : (b • Z Pressure : i . L opened At: 3 . r
R Cleaned Cleaned Cleaned
E Replaced Replaced Replaced
P Poppet Poppet Poppet
Spring Spring Spring
A O Ring O Ring o Ring
Rubber Seat Rubber Scat Rubber Seat
I
Other Repairs Other Repairs • Other Repairs
R
S
Certification
I hereby certify the foregoing data t be t and that the device tested is functioning
Within the limits of the standards � l Signed: I_e� Dated: X~ l `l /3
COLE FORD Certification 8 066455 -PM f GARY FORD Certification # 056476 —PM i ALAN FARR CerNncatba if 066431 BF
Metro Testing/ Metro Methanleal Consultants, LLC 31222 Cedar Creek ltd, Hlncldey, MN 53037 612 - 221-5833
Plumbing Bond Lice= PC646918 Mechanical Bond Cectifcato ID: 5054 -MB
This report is for the purposes of recording only; Owner is responsible for safe operation I
and upkeep of scheduled maintenances