HomeMy WebLinkAbout06-02-23 RPZ Test ReportYale Mechanical
Building Efficiency and Sustainability
A Service Logic Company
BACKFLOW PREVENTOR (RPZ) TEST REPORT
JOB ADDRESS:
OWNER/OCCUPANT/CONTACT PERSON:
CONTACT PHONE:
DEVICE LOCATION:
#1 CHECK VALVE
PSI/DIFF
FLOOR #:
ROOM #:
SERVES WHAT SYSTEM:
MAKE:
MODEL #:
SIZE:
SERIAL #:
INSTALL DATE (MONTH/DAY/YEAR):
OVERHAUL DATE (MONTH/DAY/YEAR):
(DO NOT PUT A FUTURE DATE IN THIS
BOX)
TEST DATE
(MONTH/DAY/YEAR):
DESCRIBE REPAIR IF ANY (IF THIS IS A NEW INSTALLATION AND REPLACES AN EXISTING DEVICE, INDICATE THE SERIAL NUMBER
OF THE DEVICE REMOVED):
James A. Duda CERTIFICATION NUMBER:
30726
#1 CHECK VALVE
PSI/DIFF
RELIEF
PSI/DIFF
#2 CHECK VALVE
TEST BEFORE REPAIRS
FINAL TEST
DESCRIBE REPAIR IF ANY (IF THIS IS A NEW INSTALLATION AND REPLACES AN EXISTING DEVICE, INDICATE THE SERIAL NUMBER
OF THE DEVICE REMOVED):
James A. Duda CERTIFICATION NUMBER:
30726