Laserfiche WebLink
47�5.225D <br /> , A�nual 7esting <br /> ♦ Of R.P.Z. Va)ves <br /> ,� BACKFIOW PREV�NTER T�ST REpORT <br /> AOORESS�.D ��Te.vli�o CITY ZIP <br /> �� �R avcv <br /> . 0�14tER�rce � �e►J� /fki.ye+vL�T TELEpHONE NQ. ,y7/- S78�ATE: � �� � <br /> MAKE AND MOOEL OF QEVICE �j�p,�/ 5IZE l �� SER1Al �O,l�.p,���� <br /> 14CA7i0N OF DEYiCE: p�i�Si�Je /3�c�. ,f>��� <br /> CHECK VAl,YE �►1 CHE�K YALYE N2 PRES. 11tF. PRES. �IF, STRAINER <br /> ACROSS NI WKEN REIIEF <br /> � CNECK OPENS <br /> 0 !, KE s� si <br /> BEFQRE � CL85E� CIOSED CLNO <br /> REFAIR <br /> � REPAiR <br /> t D L KED ,_,.,YpSi _��S • <br /> 1'fST ClO5E0 ) <br /> R ALS <br /> USEO � <br /> ti. CERTIFICAT1bN: <br /> . I hereby certify the forego9ng data to be correct and thaL the tested device is <br /> functioning within the limits of the standards. <br /> FI RM NAME�,Gv�R S/ �l�l�r�e3i�i�-- ADORE S S �� 8!�/�r tiA-�-� �.�l��.. <br /> . 6 � TESTER'S CERTIFICATION NO.�T'ffL. N0.�S�•'�►'�.�-&'yO3 <br /> OAIE REMARKS . . <br /> ; _ . . . <br /> . o . .. .�, ._ .. ._ . .... . . - <br /> . . ' : � <br /> . • ; . � - . � . <br /> s <br /> � � t.. � ... . <br /> v <br /> . � , . <br />