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HomeMy WebLinkAboutRPZ Test 2013 Annual • : SSOCIATED mechanical contractors, inc. 1257 Marschall Road, P.O. Box 237 • Shakopee, MN 55379 Phone: 952/445 -5100 Fax: 952/445 -5119 BACKFLOW PREVENTOR (RPZ) TEST REPORT JOB ADDRESS: �/ G J ✓1 / .0 j N. /a // / 3 - % 7 / ;, . /c' /, 5 !z,R OINNER/OCCUPANT /CONTACT PERSON: / CONTACT PHONE: I l 1 `�l�"j �SZ LZIP ° 12 O • DEV LOCATION: FLOOR*: C ROOM #: SERVES WHAT SYSTEM: /- ? // MAKE: tf �/ S MODEL #: SIZE: SERIAL: l• INSTALL DATE (MONTH/DAY/YEAR): OVERHAUL DATE (MONTH/DAY/YEAR): TEST DATE (MONTH/DAY/YEAR): z-/-,7-/ 3 tl CHECK VALVE RELIEF #2 CHECK VALVE PSUDIFF PSIIDIFF TEST BEFORE REPAIRS `— P � 6 (9 / ,5e FINAL TEST • • *DESCRIBE REPAIR IF • TEST DONE BY (PLEASE PRINT FIRST & LAST NAME): 'd 27_ [ �� � CERTIFICATION NUMBER: f�. COMPANY NAME: Associated Mechanical Contractors CONTRACTOR LICENSE #: p!tgO5 '- 0 COMPANYADDRESS:1257 Marschall Rd PO Box 237 COMPANY PHONE #: 952-445-5100 CITY: Shakopee STATE: MN zip: 5 5 3 7 9 CONTACT PERSONIPHONE#: Kevin