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:-A SSOCIATED • <br /> mechanical contractors, inc. <br /> 1257 Marschall Road, P.O. Box 237 • Shakopee, MN 55379 <br /> Phone: 952/445-5100 Fax: 952/445-5119 <br /> BACKFLOW PREVENTOR (RPZ) TEST REPORT <br /> X06 ADDRESS: es.J I"•1•1/)it j/41(1 U p.-/ ) , Z, A/'s5 err/. <br /> OWNER/OCCUPANT/CONTACT PERSON: .' CONTACT PHONE: <br /> //C47t 5 � ��/�'� v/Z Z(V-2(.-ti PS <br /> DEVICE LOCATION: /ffe'g FLOORS / ROOM : <br /> SERVES WHAT SYSTEM: )4,16_ <br /> MAKE: ief// MODEL I: • SIZE N/ SERIAL S• 4.-3// <br /> c� <br /> INSTALL DATE(MONTH/DAY/YEAR): OVERHAUL DATE(MONTH/DAY/YEAR): TEST DATE(MONTH/DAY/YEAR): <br /> 17- 23 � ' /3 <br /> #1 CHECK VALVE REUEF #2 CHECK VALVE <br /> PSUDIFF PSI/DIFF <br /> TEST BEFORE REPAIRS es eC'� <br /> FINAL TEST • <br /> ! <br /> DESCRIBE REPAIR FAIN: <br /> TEST DONE BY(PLEASE PRINT FIRST&LAST NAME): <br /> -en •'6i�s ,� CERTIFICATION NUMBER: <br /> COMPANY NAME:Associated Mechanical Contractors CONTRACTOR LICENSE S: /( S�L//�� <br /> COMPANYADDRESS:1257 Marschall Rd PO Box 237 COMPANY PHONES: 952-445-5100 <br /> CITY: Shakopee STATE: MN ZIP: 55379 CONTACT PERSON/PHONES:Kevin <br />