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