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HomeMy WebLinkAboutRPZ Test TEST AND MAINThNANCE REPORT FORM RPZ - Reduced Pressure Zone Assembly - RPZ J JJI'-f rY' ."d L <---- 3415 GLEN W A.lJ!.R TRAIL~ PRIOR LAKE GLEN WAtJ!.R WEST It} 1- Model (1-25' Y L, , LOCATION: . ~ Date: Serial# _ W t 5" 05'ff;ize . 2" r--l.-I.-"./ ....-,,)-...-;,... ThluAL TEST OF DEVICE: Check Valve #1 Leaked [ ] Closed f4-- Pres. Dif#1 Check:--2..V . PSI Pres DifReliefOpens-.b r PSI Strainer: None It! Cleaned [ ] J I Check Valve #2 Leaked [ ] Closed [~ PSI . MAJ:l' II!..NANCE OF DEVICE: Cheek Valve #1 Cheek Valve #2 Cleaned: Cleaned: Repaired: Repaired: I CHANGED OR NEW DEVICE INSTALLED: Date: I neviee Type: Model: I Manufacturer: Serial No.: Size: I FINAL TEST: Check Valve #1 ~ked [ ] Closed H- Pres. Dif #1 Cheek: ~ I f V PSI Pres Dif Relief Opens Strainer: None JQ Cleaned [ ] /,. r PSI &Off:::::atK ~/lo~lff Ct (~f &~ .J /? Comments: :restinl! Comoanv: Testers Cert. Number: .'1 fJ + Westman Plumbing 31569 Nuthatch Avenue Aitkin, MN 56431 (612)-701-4789