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08/31/2016 09:02 9529143273 MMC PAGE 05 <br /> , . ' s ' <br /> ANNUA►L. TESl'ING OF RPZ VAIVES <br /> ,�QB ApQR�SS: CITY: STATE: zIP CODE; <br /> ,Z�04 S1��d .�ce�. �d �c J a ri'�. /�� .�S.�3' I <br /> OWNER/OCCUPAI�T: tLDINC NAME; OESCRIPTION OF WORK: ANNUAL <br /> �.n����` INSTALL AI,TER REPAIR REPLACE OVERHAUI <br /> c�i� ` r`'�t3 <br /> CONTACT PERSQN: TE P ONE �iUMBER: <br /> C�.��s ��a 4� 9.�� -�7/ 9 773 <br /> SYSTEM SERVED: DEVICE LOC,�ITION: FL.O��: ROOM#; <br /> ik? � �C�'�.z 1 �� .Cr��aec .lxv�.� <br /> MAK.� MODEL: � SIZE: RI #; <br /> t���tk��s � �' 7 ��- I " 7 2.9 o g� <br /> T ST 7 : OYERHAUL DATE; INSTALI DATE: PREVI V A �Q,�TE: <br /> � ZO I� � �3 pE3 <br /> CHECK VALVE CHECK VALVE PRES.DIF. ACROSS PRES. DIF. WH�N STRAINER 2.`'� <br /> NUMBER 1 NUMBER 2 NUMBER 1 CHECK RELIEF OPENS <br /> INITIAL I,EAKED LEAKED e� NONE <br /> TEST: CLOSED CLOSED I `� pSl ��� PSI LND <br /> INITIAL TEST PASSED, SU6MIT AS FINA� IN►T�;��tEST FA14�D, REPAIR NEEOEO <br /> DESCRIBE REp�tl : � ��� ^—'� <br /> CMECK VALVE CHECK VA►LVE PRES.DIF. ACRQBS F'RES. nIF. WHEN ^. <br /> NUMBER 1 NUMBEf�2 NUMBER 1 CH�CK REUEF OPENS <br /> FINAI <br /> TEST: CLO5ED LOSED _ Pal i � PSI <br /> TEST PERFORMED BY; �F271F!cAT?'^�v�!I►MBEF�' <br /> �4ut.4 �� 2QQ�,;B <br /> ; . <br /> �,M�ANY NAME: COMPANY AD�RESS: CITY ,�TA� '�F`�„�j,� TELEPNONE NUMBER: <br /> METROPOLRAN 7340 WASHIN(3TON EDEN MN i 553dd 952.941.7010 <br /> MECHANICAL CONTRACT�RS AVENtJE SOU7H PRAIRI� , <br />