HomeMy WebLinkAboutbackflow preventor report JUL-11-2014 09:57 P.002
BACKFLOW PREVENT�R (RPZ} TEST REPORT
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Site Address: �7
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Device Location on Site: Zt�-�c ������ �-n �. L� , .
Contact Person: Irrigation by Design, Inc Phone: 763-559-7771
Serves What System: Irrigation
Test Year(check one): �New Install�1st �2nd a3rd �4th �Overhaul
Manufacturer Model Size Serial Number
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Install Date (M/DIY): Overhaul Date (MIDIY): Test Date (M/D/Y):
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#1 Check Valve - psi Relief Valve - psi #2 Check Valve
Test Before Repairs:
�inal Test: � .� ,� � n
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Describe Repairs, if any:
Test Done By: 1 Certification
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( rint first and last name)
Company Name: Irrigation By Design, Inc Contractor NA
License:
Company Address: 175 James Av. N. Company 7g3-559-7771
Phone:
City: Minneapolis State: MN Zip: 55405
Contact Person: Lori Waters Phone: 763-559-7771
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