HomeMy WebLinkAboutRPZ TEST 7/15/200
l\1ETRO TESTING
31222 Cedar Creek Road
Hinckley, MN 55037
612-221-5888
Backflow Preventer Test Report
Annual T osting
of R.p.z. V slves
It ui)GJ [)c, k:.~
I Address. /S6~S hs~ PT
[Owner ml) ')17
I Make an~ model of Device LJATrS (1c.~ '1 Q T
I Location~fdevice il-,.,J7~Y 6..~/IEK5
L fl.1 ( Check .' l:heCk VaJve'Pres dir across
--- 9 {/J$!. valve #1 # 2 # 1 Che<;k
J ?;'<tt55' ~~p+-
;/'-<1(,''''' !~._.__,____
)z'D S.c City
Telephone #
Zip 555')'2
I)-IS--()S
Date
Size :>> 'I
Serial # (/ '( ~'l('7
'----.
. ,. -.
Strainer
Test
Final Test
Leaked9) Leaked ( ) psi
Close ' Closeol-L.'l,' _
~ t' 2-
, ? '2 ,
I
S.'2.
psi
NODe ~_
Clnd ( )
Final Test
L..,ked () Leaked ( )
Closed ( ) Closed ( )
_!Jsi
_psi
MaLenals
used
Certificatio,l
[he" ,by eertify the foregoing data to be correct and that the testes device is functioning within the limits of the
standards
Firm Name M 'Ira Testinu Address 31222 Cedar Creek Road Hinckley, MN 55037
By ,Garv Ford Tester's CertificatioD #l649TTel No. 6[2-221-54~1
I Date
ReUi:.lrks
v'd
"vO'll so 62 :ilnlJ
)
J
1
L__
J
/j,~ !A,ts
:METRO TESTING
31222 Cedar Creek Road
Hinckley, MN 55037
612-221-5888
Backflow Prevenler Test Report
Annual Testing
ofR.P,Z. Valves
, Address 15'8>S Mil PrR.() SE' C~ty,_iAa2 '.t.o.~
rOwner ..:jzsD -;l/~- Telephone #
I Make and model of Device L,)II.tN~ '7 ')~ ?(L Size I "
I Location,)f device J3,IIE~ f~
L I).L - Cbecl< Check valve Pres dit, across ' /'res aifwnen
r /'~' valvefil fi2#1 Checl< reliefapens
i
,
Date 7-I5-oS
Serial# !(YJ'D31'
Zip S53n )
J
}
1---
Strainer
Test
Leak9() Leaked ( ) psi
Clos ' Close~ C1
. 1.0 (,0
psi
S,Q
Non~
Clnd ( )
Final T esl
Final Tesl
Leaked () Leaked ( )
Closed ( ) Closed ( )
_fJ:.i
_psi
Materials
used
Certificatio a
I her ,by certifY the foregoing data to be correct and that the tesles device is functioning within lbe limits of the
stan, ards
Firm Name}v elro Testinu Address 31222 Cedar Creek Road Hinckley, MN 55037
By Garv Ford Tesler's Certification /I 1649T Tel No. 612.221.5481
I Date
Rem"-rks
1
"
S'd
eSO'jj so 62 ~n~
AUG-15-2006 14:13
~(..
~/l~ .., f'f 0 ~ :'
~S~
r~ .... Metro Testing
.,.... C1 ~ 2.- '-t --4:,_1 t~ 1i22 Cedar Creek lload
llineldey, MN 5503'7
611-121-5888
BacldJo"'i l'rcveater Test Jle.pott
CITY OF PRIOR LAKE
9524474245
P.01
Dare:
7-2./~6
I
- -
ColIUCC Pentlal Tel
()w1ltr:~ 7.q
. ,,y(:,? I,
Addr:els:J-j,N~,.) G).c.~S J?1,~ ~ City: ?.L/oL lA~
Make: U. f ~,J!:. ModeJ: i ? > xl, Size: I "
X;r:lI.tioD of Devil-e:
~'Ia ~
-~ellr . Cbeck V'alvttn .
J .eak<;d( )
aOl~ q ",I
c:1~N /l rrdsure ' '-t
, ~
. _ (lea_e.d
Replaced
. Poppet
. Spriag
_ 0 RiD!
_llubber Seat
Other Repairs
R
E
p
A
I
R
S
Zip:
-
SerjaJ: I 2 ~
_ oDD1'8
Serves ...b;t S,stellC
, I~d~
C.beck VaJ\le In
LtaJrM( )
Oos~
PrelCUI't 1: -z....
---a~Dcd
_ 1lcplllced
, poppet
.SpriJlg
o RioS
llubbcr Seal
Otller' llepain
· Dilf"e....nbJ "-res. Relid'
Did Not Opell_ -
!JlIeaed AtJ (J
. Clcaaed
. JlcpIaced
DilpbrJlt.a1
S,rtBI
. 0 ltiD~
. lbJbbcr seat
. ()tIMr Repain_
- -
Cel1ifieabon
1 hereby eeJ1;Il'y !hc fo.. wI!. ,jaB d.ta to be eorrttt aad that the clrvice tested ill fuudio)liDg
Withill ~e limits of tbe ,uudllroS
Firm Naroe: MrJro Tcs1igr J121~ C.-r.,C1-eek lit~kI". MN 55037,
\ l'csted By: Gary Ford Certt6utioa 1t 164,-r OR Cole J!ord Certificatioll fl.1143T
'1 hie repUll, is for the pUI"pORt::JRQCOrc1ing only; Ownc:r is responsible for safe op~ion
AJ1d u"k~ of ac;b8duled ~DaDC8, --
,....n,......,oc,,-n';'$'.
F!11I'e1
dc!:no 00 IH 6n-v
-
AUG-15-2006 14:14
CITY OF PRIOR LAKE
9524474245 P
.02
Metro Testing
31212 Cedar Creek Road
Hinck!tY, MN 55037
612-221-5888
Bo.ckflow PreventeC Test 1te~rt
Date> 7-2/-0("
-
7.ip:
fO""u'.:x; " ')1 "! - c.;;--~", 1'<1.
Atldrt8S: City:
R. ~~J ~~~ M. tJ01IL, ~(
Make:, 'I MadeJ: q.na
'-"~~ f.J.:!. I 6)r
Locsn;'; of Dc'Yiee:
P,.t;..'" ~cu~c:.. 11..Ir..t.- ~
-
TI!I\ 'Year 'Cbec1.. VaNe 1#1
[.8'kcd( )
ClosctJ>lL- "'9
/l.~,_ )'rasuI'C 0 -6
a~.t:d.
_ _ aeplaced
_ _ Poppet
spnne
.0 mag
nubDeI' Seal
()l.her Rcpain
R
E
p
A
I
R
s
d-' eMf- f..J' ~ '
8-= ~/(./ ..
- .
S.ervc:'J 'ffbat s,~tcal:
~DJ IPJ
- ~
Serial: ~?_ ~ ~
Cha:k V~.z
J.eakcd( )
CJosc~ .l-- -0 / /
, Pres~ O. r..r
_ _ CleAned
_ Rt:platcd.
po,pet
Sp.ug
OlliG
- ;
Rabber Seat
Otber Rcp"n
. riiircr~tPIJ 'reI. Relid
Di.d Not Opell_ -
o~At 3. ~
- ,...
Cleaned
-
_ 'Replaced
Diaphrall1l
_ Spri.g
Oltiag
Ilubber seat
OtIIer Repairs
-
-
...
-
- CertifICation
1 heRb} certify the forecoiDg (hI. to be co., ....: Ind that tile device te:dcd is rucdollin:
Withi.a ~e limiu ohhe studanb
Firm Name: Metro Tt;$M! 3.1212 c.~~- I6.Jt.kle't'. MIll SSUZ
Tested By: c.,.I" Ford. <.;er:tifiratio. "16-4,-r Oll Colc FOl'd C~lfificatiod 11 n43T
I This report j! lor the puIl)OSes/llc::CordinR only; Owner ill RS1)oMib1e for aatC operation
And u!'kee\) ~Jf scheduled 1!1linlcllancc.
_l ""'''''' ......"._t"\7'{"
'l!J"Vl
dzsnn 90 S ~ I}n\:f