HomeMy WebLinkAbout2014- Backflow preventor test report for division JUL-11-2014 09:58 P.003
BACKFLOW PREVENTOR (RPZ) TEST REP'ORT
Site Name: �.�a���
Site Address: ��� � ��
Device Location on Site: (�Oa � �
Contact Person: Irrigation by Design, Inc Phone: 763-559-7771
Serves What System: Irrigation
Test Year (check one): �New Insta(1 a1st �2nd �3rd �4th �Overhaul
Manufacturer Model Size Serial Number
�n 25`� 2'� �0 3ood�b
Install Date (nn��nr): Overhaul Date (Ml�n�): Test Date (M/D1Y):
�a l �� �I�lr
#1 Check Valve - psi Relief Valve - psi #2 Check Valve
Test Before Repairs:
Fi nal Test: ' 9� 3,�, ,�
Describe Repairs, if any:
Test Done By: �� Certification 2���
I � Number:
{Print first and last name)
Company Name: lrrigation By Design, Inc contractor NA
l.icense:
Company Address: 175 James Av. N. Company 763-559-7771
Phone:
City: Minneapolis State: MN Zip: 55405
Contact Person: Lori Waters Phone: 763-559-7771
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