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WEHfEL
PLUMBING & liEflTlNG. INC.
PROFESSIONALS
RPZ TEST I REBUILD REPORT
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Address
Service Name
Contact Person
Telepht)he
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City
state
Zip Code
Device Location
Device Serves What System I
Serial Number I (",/X.) R([)7
Make I L~ j ~ iT'S
Model I tJ/~9
Size I
Install Date I
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Test Year
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o 1st
o 2nd
o 3rd
o 4th
o SthIRebuild
ci. New Install
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Test Date'
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Ch k V I 1 0 LEAKED
. ec a ve q' CLOSED
Check Valve 2~' ~~~~~g
Press. Diff Across 1 I 7.. ( (] I PSI
Press. Diff Across 2 I /, ~ i~'L/1 PSI
Press Diff Relief Open I l~ I S I PSI
Describe Repair:
I HEREBY CERTIFY THE FOREGOING DATA TO BE CORRECT AND THAT THE TESTED DEVICE IS FUNCTIONING
WITHIN THE LIMITS OF THE STANDARDS
ADDRESS: 1710 ALEXANDER RD, EAGAN, MN 55121
FIRM NAME: WENZEL PLUMBING AND HEATING, INC.
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BY: r)1J'\ I j-J ,d 'rl, V IOtiXl'
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CERT#