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HomeMy WebLinkAbout10-20-2020- RPZ/PVB testingPlumbing $� Heating & Air Conditioning 4145 MacKenzie Court NE • St. Michael, MN 55376 • 763-497-2290 o Fax: 763-497-4263 October 20, 2020 City of Orono 2750 Kelley Parkway Orono, MN 55323 RE: RPZ and/or PVB testing form To Whom It May Concern, Attached please find a copy of the RPZ/PVB testing form(s) our technician completed for: Jason Pitts 225 Old Crystal Bay Road S Orono, MN 55356 Please feel free to contact us if you need any further information. Thank you, Missy Malo Pj PIlunbing , : NeatIng & U, Air ConakJonrng 4145 MacKenzie Ct NE St. Michael, MN 55376 Office: 763-497-2290 Fax: 763-497-4263 www.bclIp umbers.com www.facebool<.corTi/bdplut-nbers `�1e.•uiny 6.r« J'wee fid'-„ B & D PLUMBING, HEATING & Air Conditioning 4145 MacKenzie Court NE ANNUAL TEST St. Michael, MN 55376 BACKFLOW PREVENTORS Phone: 763-497-2290 Fax: 763-497-4263 CUSTOMER ��J S � �'� 7 / STREET ADDRESS �Z S OZ -6 G `Ys ��G 3��' 2�/tfl LOA/;' L.fN« a7,,J , S's- -7s G MAILING ADDRESS PROPERTY OWNER STREET ADDRESS MAILING ADDRESS LOCATION OF ASSEMBLY l��CIC of �/©SSC �T�2!"-Cfli6 TYPE OF ASSEMBLY: RPZ DCV SIZE: / MANUFACTURER:WCL/� 5 MODEL: 720 f} SERIAL#: ! yyl7oq NOTE: ALL REPAIRS SHALL BE COMPELTED WITHIN TEN (10) DAYS. REMARKS: I HEARBY CERTIFY THAT THIS DATE IS ACCURATE AND REFLECTS THE PROPER OPERATION AND MAINTENANCE OF THE ASSEMBLY. TESTER'S NAME (PRINT) Tho . -i3T062575 TESTER'S SIGNATURE---------- DATE CHECK VALVE #2 CHECK VALVE #2 PRESSURE CHECK VALVE #1 RELIEF VALVE TEST #1 TEST #2 VACUUM BACK PRESSURE CONFIRMATION BREAKER Air inlet opened at leaked opened at: psi leaked leaked 3, a psi did not open p closed tight did not open closed tight closed tight Differential pressure flAU$T ®PEN AT Differential pressure p Differential pressure p check valve: across check valve Across check valve Across check valve psi ALAST 2 PSI. psi psi leaked must be 3 psi Must be at least held at 9 psi above relief valve 1 psi Cleaned only Cleaned only Cleaned only Cleaned only Cleaned only Replaced: Replaced: Replaced: Replaced: Replaced: rubber kit rubber kit rubber kit rubber kit rubber kit CV assembly RV assembly CV assembly CV assembly CV assembly or disc or disc or disc or disc disc, air in o -rings diaphragm(s) o -rings o -rings disc, CV seat seat seat seat spring, air spring spring spring spring spring, CV stem/guide guide stem/guide stem/guide retainer retainer o -rings retainer retainer guide lock nuts other lock nuts lock nuts o -ring other other other other Differential pressure Opened at Differential pressure Differential pressure Air inlet psi across check valve psi across check valve across check valve Check valve psi psi_psipsi NOTE: ALL REPAIRS SHALL BE COMPELTED WITHIN TEN (10) DAYS. REMARKS: I HEARBY CERTIFY THAT THIS DATE IS ACCURATE AND REFLECTS THE PROPER OPERATION AND MAINTENANCE OF THE ASSEMBLY. TESTER'S NAME (PRINT) Tho . -i3T062575 TESTER'S SIGNATURE---------- DATE