HomeMy WebLinkAbout2014 RPZ Test Carwash #1306690 08-12-14;01: 10PM; #
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visit as at: svwwitntesdait.ciga i Winageinffilitlayad
Reduced Pressure Zone Backflow Preventer Valve&Pressure Vacuum Breaker Valve
Rebuild/Test Report
Account No.: Deadline:
Contact Persee : • Date
Mew City: Zip:
144160 1"^e.,) ii:ifi bit NI 0 it L ke 5'5 3V
kit
Mode;: Size Serial etf:
jig:Ikon 17s x4 I "
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'1415)eb 4 lida..:0430.111 Roo s4.1 Install Yr: Rebuild Date
WA Pada
, Jie'IA k reggirlidi a k OwrhailedNGetis"MNAlin&Mitt 471121‘1,1
Test Yr.—:—. Cheek Valve #I Check Valve #2 Differential Prada Relief
toga' Leaked( ) Closed( S Leaked( ) Closed( JO Did Plot Open( )
L 2 4
erhauied ( ) Pressure: 2r" Pressure: ?t 3 Opened At: P.15)
TALL( )
R Cleaned Cleaned Cleaned
E Replaced Replaced Replaced
P Poppe Poppet Poppet
A Spring Wail Spring
I O Ring O Rias 0 Rheg
R Rubber Sees Rubber Shat Rubber$eat
S Other Repairs Other Repents Other Repairs
tcation
t hereby certify the f be correct and that the device is tested is ftnetiening within the limits of the standards.
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Signed: A, p Dated: 0 a'q'i
ti
Tested by: GARY PORD Certification 11058476-PM or COLE FORD Certification#066445-PM
res Name: Metre Teet3n8/Metro Macbsnicat Coaselmtts,LLC Address: 31322 Cedar Creek Rd,Dlseldey,MM 5503
pluebing Bond License #: PC646913 Mechanical Bond Certificate ID it: 5054-MB
This reportfrfbr the putp see of Reseg Only;fhaebravossi8eleforsoftopsradon and upkeep of
s t- and ref el annual schatgvtestt matafaa,, -,L MNLswe; 471£2161 1-3
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