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HomeMy WebLinkAboutB Backflow Preventor Test Repory ASSOCIATED 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 JOB ADDRESS: C ����« G� V J`-5-39rrq �zlvd / OWNER/OCCUPANT/CONTACT PERSON: r CONTACT PHONE: � e2,0 if _ U 17 - Z/:U- 2 C'lr� DEVICE LOCATION: " 1� �j� 1 FLOOR*: / ROOM If: • SERVES WHAT SYSTEM: ,4 r, , MAKE: (, MODEL#: Z � SIZE: �� SERIAL*: 3�--r 7// INSTALL DATE(MONTH/DAY/YEAR): OVERHAUL DATE(MONTH/DAY/YEAR): TEST DATE(MONTH/DAY/YEAR): "./e-/z7/ NF1 CHECK VALVE RELIEF #2 CHECK VALVE PSI/DIFF PSI/DIFF TEST BEFORE REPAIRS . ,2 kQS&C" FINAL TEST DESCRIBE REPAIR IF ANY: TEST DONE BY(PLEASE PRINT FIRST&LAST NAME): CERTIFICATION NUMBER: O CT/'r-s/t"e 6_3 W 6,6ft COMPANY NAME:Associated Mechanical Contractors CONTRACTOR LICENSE D: P11103-91-11 COMPANYADDRESS:1257 Marschall Rd PO Box 237 COMPANY PHONE#: 952-445-5100 CITY: Shakopee STATE: MN zip: 55379 CONTACT PERSON/PHONE*:Kevin