Laserfiche WebLink
NewMech <br /> 1633 Eustis Street <br /> St.Paul,MN 55108-1219 <br /> Compardes,hu. (651)645-0451 FAX:(651)642-5591 <br /> 75 Years of Excellence httpJh vww newmech com <br /> 1633 Ems Street 4715.2260 <br /> Salt Paul MN 55108-1288 BACKFLOW PREVENTER TEST REPORT Annual Tes*g of <br /> (651)645-0451 /} R.P.Z.VaNm <br /> - DATE: G `��" �3 <br /> A.O .>ob# �l JL5 <br /> see Address: v �►: U �D ode: 553 <br /> .ContmtDS Phone M. <br /> Owner: Phone#: <br /> Owner Ate: CBT: Zip code: <br /> Make and SIZE: SERIAL.#: <br /> Model of 35 <br /> Devim- S - <br /> LOCATION , ! <br /> OF DEME: (G <br /> SERVES WHAT <br /> SYSTEM �dQ -- <br /> Check #1 Check Valve#2 Pres.off. Pres.Ex Straite r <br /> Across#1 When Rem <br /> Check own <br /> TB&We Gose ((k Close (� _ PSI _ PSI cm ( ) <br /> Repalt <br /> Describe <br /> FW Leaked( ) Leaked( ) _ PSI _ PSI None ( ) <br /> Test Close ( ) Close ( ) cmmalleflals <br /> ( } <br /> Used <br /> CERTIFICATIM <br /> 1 hereby cm*the loregotng dais to be corned and that the testes device Is hww torfg wi tt the bft of the . <br /> HIM Wim: NEWMECH CO.M. ADDRESS: 1633 EUSTIS STREET ST.PAUL MK 55108 <br /> BY: � �� cmTIFICATION t 614;K- PHONE: 6 :s�( �s <br /> DATE: P 0PINAWCS• <br /> O INSTALL wk,'ST D REBUILD ORIGINAL INSTALLATION DATE D D <br /> DATE OF LAST REBUILD: <br /> -BFPTR P". ill= <br />