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HomeMy WebLinkAboutRPZ Test ,.,. TEST AND MAThuhNANCE REPORT FORM RPZ - Reduced Pressure Zone Assembly - RPZ Address: 3304GLENWA.l.l!.R TRAIL. PRIOR LAKE, Owner: GLEN W AIl!.,R WEST Date: Make WILK Model 975XL Serial# 1063061 Size LOCATION: f2 L,t-,./ 2" JJu I...AL TEST OF DEVICE: Check VaIve #1 Leaked [ ] Closed fs<i Pres. Dif #1 Check: 6J. 0 PSI Pres Dil Relief Opens, Lv ~ PSI Strainer: None M- Cleaned [ ] .J Check Valve #2 Leaked [ ] Closed P<i PSI .. MATh ...I!.NANCE OF DEVICE: Check Valve #1 Check Valve #2 Cleaned: Cleaned: Repaired: Repaired: CHANGED OR NEW DEVICE INSTALLED: Date: I Device Type: Model: I Manufactu.l;.ia. Serial No.: Size: FINAL TEST: Check Valve #1 Leaked [ ] Closed t4 Pres. 00#1 Check:--4 ~ PSI Pres 00 Relief Opens 1._ t PSI Strainer: None VI Cleaned [ ] Comments: o/~ ~, ~ Signature of Certified Tester TestinC ComoaDv: Testers Cert. Number: vI Ji C..,r Westman Plumbing 31569 Nuthatch Avenue Aitkin, MN 56431 (612)-701-4789