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Home My WebLink AboutRPZ Test 2/3/2012 03/26/2012 13: 03 7634287656 GRMECHANICAL PAGE 02/DAD Wp __. G R Mechanical, Inc. _ _ _ Anneal RPZIBackflowTest Poo( 12401 Iromrrooc" hi+cie Rogers, MN 55374 763 - 4232663 Fax: 763-428-7656 Date: 3 Customer: Site Address: ► t. +(Y. Mf alto' 4 PAC P. flit yr 1y t S flf Y ‘E.Wv,MN Contractor: G R Mechanic, Inc. Master Ricense # PM061337 Address: 18401 Ironwood Circle; Phone: 763-428-2663 Rogers, MN 66374 Fax: 763 428 - 7656 Location of Device: all go% Device Serves: ifflESIM Make: 14 1(6 ►� Model: ? Size: �� Serial #: y7,1714 Check Check Pres. Olt: Pros Dif Valve #1 Valve #2 Across #1 When Relief Strainer Test before Leaked { '} Leaked { } PS PSI None { } Repairs Closed { } Closed { } Chid { Final Test Closed Closed PSI 'j 3 P81 Cleaned only: { Cleaned On { Replaced: Replaced: Rubber kit { } Rubber kit { } CV Assembly { } CV Assembly { } O -rings { } O -rings { } Seat { } Seat { Spring { } Spring { Stem/Guide { } Stem/Guide { Retainer { } Retainer { } Lock nuts { } Lock nuts { } Other {_} Other { } Describe Rapalres R s ki. 13 RemarI : I hereby certify that this date is mate and reflects the proper opar ion and maim of the assembley. Teeters Name (Print ;,/ I;�1 ! . Certification # 66 l e- Testers signore: , �._ .. Date: _ �" 2.