HomeMy WebLinkAboutBackflow Preventer Test 12/11/2014 12-15-14; 11:54AM; ; # 1(02
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Reduced Pressure Zone Backflow Preventer Valve&Double Check(DC)Assembly Valve
Rebuild &Test Report
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Install Yr.: ttihuikl flaw:
A600 ,
T t Yr. Check Valve#1 Check Valve#2 Di -ntial Pressure ' . 7
1 2 3 4 Leaked( ) Closed(, Leaked( ) Closed(•kf Did N. " ( )
Ovc uuled( )
Install( ) Pressure: ,9)./) Pressure: a,./..) O. ' . i At:
R Cleaned Cleaned Cleaned
E Replaced Replaced Replaced
Poppet Poppet Poppet
r Spring Spring Spring
A O Ring O Ring O Ring
Rubber Seat Rubber Seat Rubber Seat
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Other Repairs Other Repairs Other Repairs
R
S
1 Certification #2 Shutoff Valve:
I hereby certify the foregoing data to be correct and that the device tested is Pass
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futioning within the limit of the standards. Fail
Signature: , ►i
Date: 1:744,Pi Assembly Final Test
Performance:
• cous FORD 11F066445 I GARY FORD 8Y055476( ALAN FARR liFIWARI
Metro Testing/Metro Mechanical Cmunttantr,l.LC 3122E Cedar Creek Rd.Hinckley.MN 56037 612.22I,588$ Pass
Plumbiu5 Bend Uccnsc PC646915 Mechanical Bond Cenifieate ID:5034-MB Fail
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This report is for the pdtpose a i g' is responsible far ss c operation and upatocp of stheduied minion:woe.
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