HomeMy WebLinkAbout2008 Irrigation I .
P&H SERVICES CO., INC.
Plumbing I Heating & Piping
1601—67th Avenue North'Minneapolis,MN 55430-1743
Office:763-560-1080"Fax:763-560-0164
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To: 7 V ',� C,/,('oitiD Date: 67/7-46Y
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Attn: lenti<fLDL ) 1)07- • Our Job No: OW/'3S
.'.)From: U ) _ Your Job No:
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VSFax; ,� Pages Including cover sheet.
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FOC li. �(2- O 1.-i)6.065 i9pi-s
[i For approval I ] Approval as noted • )/ For your files
Other
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transmission in error,by disclosure,copying,distribution or reliance thereon; please notify us immediately by telephone(collect)at 763-560-1080
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P&II SERVICES CO., INC.
PLUMBING *HEATING & PIPING
1601—67'Avenue North•Minneapolis,MN 55430-1743
Office:763-560-1080 t Fax:763-560-0164
Backflow Preventer Test Report
Instructions to Certified Testers: All information must be typed or clearly printed in black ink.
Site Addres•� Z3 z„ 4'
, A r
City: Zip Code:
Occupant: Telephone: Test Date:
—129 � (
J*/ two 1 �5 ,j > •7 o'1
Device Ma Size: Serial No.
AIV4(le A4.-5/ a/Ott
Device Model: I�� i > 9
Test Period: Overhau •tall 1st Yr 2nd Yr 3rd Yr 4th Yr
(Circle One)
`
•
Device Location:
d&Y12liiDevice Serves Wystem:
PRES DIF CHECK PRES DIF
ACROSS VALVE WHEN RELIEF STRAINER
# 1 CHECK #2 OPENS •
Test Before None "
Repairs psi Closed ( ) psi
Final CLND ( )
Test psi Closed psi
Describe Repair if any:
V4 f444-
If this is a new installation and replaces an existing device,
Indicate the serial number of the device removed.
CERTIFICATION:
I hereby certify the following data to be correct and that the tested devise is functioning within the limits
of the standards. /
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Certifie V.%f'. :AO/�. _ .d / _ Certification e=5��`1
ignature)