HomeMy WebLinkAboutRPZ Backflow Preventer Test 5.28.15 C`ORVAL ROUP-,.
1633 Eustis Street, St Paul, Minnesota 55108-1219 (651)645-0451 Fax: (651)642-5591
An Affirmative Action, Equal Opportunity Employer /3 zzoGKNor 77oz_
TO: Phil Pagel DATE: 5/28/15
YMCA Burnsville PROJECT: RPZ Testing
13850 Portland Ave S LOCATION: Camp Kici Yapi/ Prior Lake
Burnsville, MN 55337 OUR PROJECT NO.: 4010
WE ARE SENDING YOU:
®Attached ['Change Order ['Specifications ❑Shop Drawings
['Under Separate Cover ['Copy of Letter ['Prints ❑Request for Change
❑Thru Messenger ['Plans ['Samples ['Purchase Order No.__
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1 1 Backflow Preventer Test Report Serial# Unknown 3
TRANSMITTAL CODES: 1. For Acknowledgment 6. Approved as Submitted
2. For Approval 7. Approved as Noted
3. For Your Use 8. Resubmit Copies for Approval
4. As Requested 9. Release for production as per delivery date indicated on our Purchase Order
5. For Review and Comment 10.Furnish changes in contract price,if affected,by
11. Other:
REMARKS:
Copy To: 1. Project Manager File 2. Follow-up File
Corval Constructors, Inc.
City of Prior Lake
6
CORVAL GROUPTM
BACKFLOW PREVENTER TEST REPORT
DATE: /1,3 7/5
Site Name: Camp Kici Yapi Job# _
Site Address: 13220 Pike Lake Trail City: Prior Lake Zip Code: 55372 _
Contact: Phil Pagel Phone#:612.247.3687
Owner: YMCA Burnsville Phone#: 612.371.8709
Owner Address: 13850 Portland Ave S City: Burnsville Zip Code: 55337
Make/Model of Device: Watts 909 Size: 2" Serial#: Unknown
Serves What System: Pool Fill Location: Mechanical Room
Ck Valve Pres. Dif. Across Pres. Dif. when
Ck Valve#1 #2 #1 Ck relief opens Strainer _
Leaked ( ) Leaked ( ) None ( )
Test before Repair Close ( ) Close ( ) PSI PSI Clnd ( )
Describe Repair _
Final Test Materials Leaked ( Leaked 'r None (N)
Used Close (A Close A $e1 PSI Li.APS! Clnd ( )
CERTIFICATION:
I hereby certify the foregoing data to be correct and that the tested device is functioning within the limits of the
standards.
FIRM NAME: Corval Constructors, Inc. ADDRESS: 1633 Eustis Street St. Paul MN 55108
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BY: CERTIFICATION#: 09 S56 ( PHONE: 651-645-0451
DATE: 5/13(i5 REMARKS:
() INSTALL (5 TEST () REBUILD ORIGINAL INSTALLATION DATE:
DATE OF LAST REBUILD: 2012