HomeMy WebLinkAboutRPZ Test Report 2015 BACKFLOW PREVENTOR (RPZ) TEST REPORT
JOB ADDRESS:
6 5-1-1g -//arbor (keg) - Prior Lake ,. WI k
OWNER/OCCUPANT/CONTACT PERSON: CONTACT PHONE:
M U.i f‘\i ettAkce, -- 6 • q,5-a -45-19- to s-- It
DEVICE LOCATION: FLOOR#: ROOM#
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SERVICES WHAT SYSTEM:
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DEL#:2t4 y n 9 7s SIZE: " SERIAL#:MAKE: MO
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I INSTALLED DATE: OVERHAULED DATE: TEST DATE:
5/5 iaoks (5 ii *
SUM mos.
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#1 CHECK VALVE RELIEF #2 CHECK VALVE
PSI/DIFF PSIIDIFF
Test Before Repairs
FINAL TEST 7 , 44 3
DESCRIBE REPAIR IF ANY:
iNiel,11 epi 1- c4E40301 k i
TEST DONE BY: (PLEASE PRINT FIRST&LAST NAME) CERTIFICATION NUMBER:
Rai eery,");Aa r is F O 4,01 c
COMPANY NAME: SEITZ BROS.,INC. CONTRACTOR LICENSE*: PC644372
COMPANY ADDRESS: 8608 XYLON AVENUE.N. COMPANY PHONE#: 763-425.8700
CITY/STATE/ZIP: BROOKLYN PARK.MN 58446 CONTACT PERSON: TROY A.SEI1Z
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