HomeMy WebLinkAboutRPZ Test Fire System 8.14.13 FROM (THU) 8 18 2018 11 :84ZST. 11:28/No. 8001787484 P 04
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MG I i"..... TASTING
M EC H ANICAL
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Reduced Pressure Zone Backflow Preventer Valve & Pressure Breaker Valve •
Rebuild & Test Report
Business:
Contact Person/PeL: Date: .jq s. $ ��
Avid Fit;�Vt� .rci ilm boil vo °1ST- 2217 -W54
Address: City I tip.
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1 0 a J tl mss n w ` Prf pY L
Serial #:
Make: tai Model: 7000 I S[ze: N J rl1 i49 • / Il ►its
Location of Device: Served what System:
' g t ; i tie 2061Yl - 'r? Skis-ler
Install Yr.: • Rebuild Date:
V X) ti
Check Valve #2 r •. a - -�. tial Pressure R . e
T • t Yr. Check Valve # 1
1 0 3 4 Leaked() Closed (X) Leaked() Closed Did ,, Open ( )
....tiled () a 2
Install () Pressure : T iny . P ressure : - T Open: , • t:
Rcp laced Rep
Cleaned Cleaned 1 r
E R Clad Replaced Replaced
li oppet Poppet Poppet
P o�B
P Spring Spring Spring
A O R O Ring Rubber : t
Rubber Seat Rubber Scat
I Other Repairs Other Repairs • Other ' epairs
R
S • Certification -
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I hereby certify the foregoing • :: !.. , ,erect and that the device tested is functioning
Within the limits of the star . : . Dated: g /P�1
/
Signed: -
COLE FORD Certification # 066455-PM I GARY /ORD Certification if 058476 —PM 1 ALAN FARR Certlneation # 066481 BF
Metro Testing/ Metro Medutale l Consultants, LLC 31222 Cedar Creek Rd, fdlnekiey, MN 55037 612 - 221.5888
Phunbing Bond License: PC646918 Mechanical Bond Cectifcate ID: 5054 -MB
Owner is responsible for safe operation , :.•
This report is for the purposes of o ( scheduled maintenance.
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