The URL can be used to link to this page

Home My WebLink AboutRPZ reports •�``�r E an M�chanical Contractors Inc. � � � � � 13uilding Iiitegr.ited Solutions'� BACKFLOW PREVENTER TEST REPORT Instructions to Certified Testers: All information must be typed or clearly printed in black ink. SITE ADDRESS: � �O ZIP: � �o�f s�� .� OCCUPANT: PHONE: TEST DATE: IY�,'r�n.�-�,�. �' -�,- .� --�� o--�v --�v DEVICE MAKE AND MODEL: SIZE: �� SERIAL NO. �-s �� --� � ��s y�.�' DEVICE LOCATION: /� 1 ,�. �o � 1�� T;'/',e /"�'��f,�� -� (',�.�.� DEVICE SERVES WHAT SYSTEM: �-–� jQ 1__�, � � � �� /`�/',2 /'o /zf'' u O✓l � � �✓ r CHECK VALVE # PRES. DIF. PRES. DIF WHEN CHECK VALVE #1 2 ACROSS #1 RELIEF OPEN STRAINER CHECK TEST BEFORE LEAKED ( ) LEAKED ( ) NONE {�- REPAIRS CLOSED ,� CLOSED (�^ —Psi —PS� CLND ( ) / � FINAL TEST CLOSED ( ) CLOSED ( ) _psi _psi DESCRIBE REPAIR f� �.�/ 6 CERTIFICATION: I hereby certify that the foregoing date to be correct and that the tested device is functioning within the limits of the standards. FIRM NAME: EGAN MECHANICAL CONTRACTORS ADDRESS: 7100 MEDICINE LAKE ROAD �l�/�F' ��C��1 TESTER'S CERTIFICATION #�0-�3�v3`7�PHONE #: 763-595-4300 SIGNATURE OF CERTIFIED TESTER FAX #: 763-595-4346 7625 Boovc Avenue Nortii,�` �+ /�►_��__ Brooklyn Park,MN 55428 n �►�a��„ro Main 763,54A�,4(31 Fax 7d3.595,4346 Am�ia►n Com�anY � www ega��co.cpm BACK�LOW PI�EV�NTER TEST RL'PQR.T lnstrucUorws to Certified Testers: All information must be T ed or ctearl �intAd in black ink � SITE ADDRESS_ � �O g i, S �+ ,/ �,C�� -�`f-- Z�p;SS�'-p Of��'S 73�i OCCUPANT:�I�I.N��t/,� PHONE: �� TEST DAT�; �'.l� .. �� < < l� OEVICE MAKE/MODEL• ��,(7� ppCa' �jj��ZE; SERIAL NO. I7�7 DEViC� LOCATION: � � � • SYSTEM bEVICE ` �.SERVES: G�/�-C. c/ (,�,�-C/� CHECK VALVE CHECK VALV�# pRES. Dl�. PRES. DIF � #� 2 ACROSS#1 WHEN RELlEF STRAINEf� CH�CK OPEN EST BEFORE REpAlRS �'�� LEAKEp ) �' � � CLOSE CLOSEi� "----ps� ��--ps� C ND ) „ FINAL.TEST CLOSED ( ) CLOSED ( ) � ---Psi „psi D�SCRIBE �O ��. REPAIR Certification: !hereby certify th$t the forego,ng d�te to be correct within thQ lim;ts of the standards, �d that U'+e tested devic��s funCtioning FIRM NAME: EGAP! MECHANICAL CONTRACTORS ADDRESS: 762 OONE AVE. BY• 0. �� TESTEFt�S CERTIFICATION # Io� -r, PHONE#: 76 - I��T�E�CERT1FIEp �gka Cotbpaqfcs, rn�. 3 595-4300 Bgsn Mecha,rt{cAl I gan-,McKa y�te c t r i c a l 1 Niet�E[eolric, I�,e, . I Fsgan Automation � inter F�#; 7 �-�95-�'6 . AhA�rmo�tive�lctiort/1•',q��lOn�r�� E an Service �J'Gip/uve� �� . Zd Wdbz:L0 b00Z 0� 'daS : 'ON Xd� : W021� � � , ,�� ; Egan Service � ' � �� 7625 Boone Ave. No. , € �� - Brooklyn Park, MN 55428 , ; Phone: 763-732-7411 euildiny ori Promi�e.e Kept°�-�-' FBX: 763-595-4346 �.rl_l_11r1O To: CITY OF ORONO Attn: INSPECTIONS From: BARB JACOBSON Date: September 1, 2005 Re: RPZ TESTING ❑Urgent � For Review ❑ Please Comment ❑Please Reply �For Your Files . . . . . . . . . . ENCLOSED PLEASE FIND THE RPZ TEST REPORT AT MINNETONKA CENTER FOR THE ARTS ON 8/22/05. I UNDERSTAND IF TESTING ONLY IS DONE, NO PERMIT IS REQUIRED. �2ECEIVEQ P 0 2 2005 OFURONO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � FROM : � • FAX N0. : Aug. 28 2005 10:21PM P6 . � .7G25 Boone Avenve Nortti M Drtwklyn Park,•MN 5542R � ��11 Se�W Main 763.544.4131 � � �ax 763.595.4346 An$gan Compa�ny . www ega�co.c.om BACKfLOW PREVENTL�R TE'ST R�POR.T (nstructiorts to Certlfied 7esters: All infOrmaGOn mt�st be T ed or Clearl rinted in blaCk ink � SITE ADDRESS: p�.�, � � -� s �rv.� a� z�P: S 39 �r, 4CCUPANT_ �,�,�-�r o�'� PHONE: T�ST DAT�: ��-» —�- DEVICE MAKEIMOD�L: � S d n�t I�ZE: a•r r..,. � ... ,. SERIAL NO. .S� DEVICE E.00ATlON: ,�j o � � . � SYSTEM DEVICE SERVES: /�J�Q/�-G. v � CH�CK VAl.V� CHECK VALVE# � PR.ES.�DIF. PRES. DIF � #1 2 ACROSS#1 WHEN RELfE� STRAINER CHECK OPEN ES7 BEFORE REPqIRS ��KED ( ) LEAKED ( ) �SOps� �� NON CLOSED CLOSED�� C[.ND ( ) � - FINAt�TEST CLOSED ( ) CLOSED ( ) �,psi __,nsi ' � DESCRfBE u� � REPAIR Certification: . I hereby certify that the foregoing date to be correct and that the tested cievice is functioning within the limits of the siandards. � FIRM AME: EGAN MECHANICAL CONTRACTORS ADDRESS: 7625 BOONE AVE. NO. � BY• �'�- TESTER'S CERTIFICATfON #�i�o3�o3'7--'�SMON�#: 763-585-4300 oF imr�sr�n E�an Companees,Inc. FAX#�: 763-595-4346 Egan Mechanicai i Egan-McKay�Icctrical � Nietz�lcctric, inc, 1 Egan Aulomation ( InterCl�d � Egan Service An A�'`nm�r�ive Action/,E'qz�a!U/�portuniry Emp/v�rr r -�► —"�'� Egan Service 7625 Boone Ave. No. Brooklyn Park, MN 55428 �� Phone: 763-732-7411 t3itildrny on Pron��ie�e KE�pr --� FBX: 763-595-4346 RECEIVED �MO AUG 0 9 200 6 CITY OF pROfVO To: CITY OF ORONO Attn: INSPECTIONS From: BARB JACOBSON Date: August 8, 2006 Re: RPZ REPORT ❑Urgent � For Review ❑ Please Comment ❑Please Reply �For Your Files . . . . . . . . . . ENCLOSED PLEASE FIND A COPY OF THE TEST REPORT FOR MINNETONKA CENTER FOR THE ARTS DONE 8/2/06. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . FR�M : , � FAX N0. : Aug. 02 2006 04:55PM P5 � 762:Boone avrnue North � � E Broakl��i Park,lvf!M 554'_8 � �rd'n ��1Q Main76�,54�.4531 ��rrbi�l� W Fax."-63.595.4346 An Egan CompawY www.[p,'aaco-Clfar BACKFLOW PREVENTER TEST f�,EPOR.7" lnsvucUonS!o CertiEied Testers� Af�information must be 7 d or cfeari rinted fn black ink � S1TE ApDRESS• � ;/ C;!/ ZIP: ��'3 `� OCCUPANT: � �PHONE: TEST OATE: S�a ,/ Z� DEVICE MAKE/MO�EI�t/' � �S�ZE: � SERIAL NO. J�"� pEV(CE LOCATION_ � t36*e-� SYSTEM DEVICE �� s�Rv�s: Gl�- (/ CHECK VALVE CHECK VALVE# PRES. DIF. PRES. OIF . #,� 2 ACROSS#1 WHEN RELIEF 5TRAINER CHECK ��N EST BEFOR�REPAlRS �KED O t�AKED O � ps� P51 NON�'r'� � CLOSED ( ) CLOSED( ) CLND( ) . FiNAL TEST CIOSED�/ CL�S ��si •��,psi /� . DESCRIBE � . REPAlR Certifiication: 1 hereby cettitY that the foregoing date to be correct and that the tested device is fur►ciioning witFftn the[imits of the sfandards. FIR ME: EGAN ECHANICAL CONTRACTORS ADDRESS: 7625 B�ONE AVE NO. _ � . TES�R'S CERTlFICATION#�00��31 PHONE#: 763-595-4300 Egaa Compsai�s,lnc. FAX#:763-595-Q�34-6 SIGNA7UREOFCERTIFI�D,T�� anAutpmattnn tnterClad � F+an enico ' £gat�Zvfechan�cdl ( Egsn-McKaY Electrical J ?dietz Flectric,lnc. I E8 � S 5 �a A�rmutive Ac�ioniFqua!Oppnrrunin'Fm,�1u��er i?�/20/2009 20:47 7637672855 DALE BOCAN PAGE 05/07 , ' , . � f��j�'IV�D ?625 BOOnc A.veque North. • ,� � • 8rooklyn Park,MN 55428 � �gar� Ser�ice , . 2009 Main 763.544.4•131 � �'�� { �ax 763.59�.4346 � An EgaA Compaay www.�ganco.cru,i - . , cinr oF oRorvo .: BACKFLOW PREVENT�R TEST,REPOR.T . , � fnstructions to Certified Testers: All information must be T ed or cleari rinted ir�bl�,c(c ink . ' ��, �,� Z1P: � Sf?�RDDRESS: �v�-� I�I.I . OCCUPANT!/l�i1 �rt�� PHONE:. � TEST DATE: �--e� , rr � . DEVICE MAKE/MODEL:� d�l � ��Z�= � � SERIAI�NO. I J �"� ��.fi �/ DEVICE �OCAT[ON; � ..�' �� SYSTEM DEVIGE /�� ,�% ��c� � . ��_. G•ci�..f�.+� v.� /-e°�" .. . _ _.. SERVES. �� 'd`-"' ` . PR�S. DIF. � PRES. pl� � � � CHECK VALVE CHECK VALVE# ACROSS#1 WHEN RELIEF STRAINER � #� z CHECK OPEN (�EAKED( ) L.�AKED ( } . . NONE - EST S�FpRE REPAIRS CLOSED ( ) CLOSED ( ) pS� psi CLND ( ) . F1NAL TEST CLOSE�--�• Ci.OS�D� �!j�ps� ��psi . DESCRlBE � � REPAIR � ' Certification: • � 1 hereby certlfy that the foregoing date to be correct and that the tesfeci.device 1s tunctioning � withir�the limlts of the standards. • • • FfRM NAM�: EGAN MECHANICAL CONTRaGTORS ADDRESS: 7625 BQONE AVE. NO. _ gy; �. c� TEST�R'S CERTiF1CATION # 7 PH4NE #: 763�595-4300 � . " . . $gart CoJmpanies,inc. • FAX #: 763-595-4346 ' S1Q/�fATURB OF CPFl�tFIED TEST61i Egan Mechanical,1 Egsn-McKay Electricat I Nietz ElectFic,(nc. � Egan Autamaciote I InterClad � Egan Service � ,�Jp�J(jmmative.letion/Equof ppporruteity E�npfoyer ' , • � 08/04/2009 20:49 7637672855 DALE BOCAN PAGE 69/10 , , • . . . ' ' . _r��ar-��'I�" . T • . 7625 Boor�e,A.venue Ttocth � � Brooklyu Park,MN 554z8 �- E a� Ser�Ece . � . � �ain'763.54�.4131 � � Fax 1G3.595.4346 � �� An Egan Company �vwwegnncn.cnue �BACfC1=,�OtN PR�V�,NT�EFt TES'T I��POF3.T � . �nstrucUdns to Ce�titied Testers: All lnformation must be r ed or ciearf pr�nted in biack ink a � � ' � � AD a . OCCUPAN7: � • PMONE: TEST DATE: � -,a � � �� -fi..s� . . . . � � �� Q�r �. `/ � � DEVICE MAKE/MODEL: S(ZE: SERIAL NO. �7:� ?� pEVICE LOCATION: � f�►.� � �`¢-P�� , . • . SYSTEM DEVECE� ��dt, �� r� �� L,�� S�RVES: � . �� CHECK VALVE CH�CK V,4LV� # �'RES. DlF. PRES. Q!F - #i 2 ACROSS #1 WH�N RELIEF S'CRAINER . CHECK ' OPEN � LEAKED ( ) LEAK�Q ( ) � N�NE�-}-.. EST BEFOR� R�PA(RS CLOSE� ( ) C�OSED { ) - --pS� � �51 CLND ( ) . � FINAL TEST CLOSED LOS •� G�psi � �_��s� DESCRlS� � � � REPAIR . � " Certification: � . : � � I hereby�e[tity that tite foregoing d�ie to be correct and that the tested device is functioning . ' • within the limits of#ha standards_ ' . . . � .FIF� AME: EGAN MECHANICAL. CQNTRACTlJRS ADDRESS: 7625�BOONE AVE. NO. � . � „ . . . gy; � �EST�R'S CERTtFfCAT10N #� �7 PHON�#: 763,595-��00 SIQNATUREOFCERTIFIED;7ES'rER , .. EB$� Cor�p;o;�s, Iac. � . FAX #: 763�595-434� • Egan I�echanica! f Egan�McKay•�lectri�al � Nietz,�2ectric•, Inc: � Egnn Automaiion I In,te�rCt�d { Egan Sez�ace , ' . .4n Agrnmrtve.4cito'�,Equal Q�poi�unit�Emplvycr . • � , 08/19/2010 14:25 FAX 7635954346 THE EGAN COMPANIES �J002 68/18/2610 64:16 7637672855 , DAL.E BOCAN PAGE 05/06 . , ' �' ' �' "_ . �.......____ . .n..x .'+..... ..��..ti......r � �. ' pvvir Mva. I � ; I � . � . .. � �� , . I (�� i . � � . � ! �� i' . . . ' � � i F� � i .�� t � ', � , , . � .,� � . . .• ' � i ., . : . � , � i • !Y}NA�FoAProwUaiKfjlR•••�•'� , , �. .. � : � �Ac��Qinr��n��-E�r r�sr R��o�zr! ,.,, �__.. „,„ ._. , ._..._,.. .,,,._..� ; . , In■truoaQns to Oortl}fed'Teatsra: All Infgrmation muat b Tyqed Or olesrl�prirdod In bladc ink � SIT�AQDR�SS: 'Eil2� U hct./1� f` � lp; S.�"". , ; . � , , � C P NT: `' PHON�; � T� T DAY�: -' ., -- O ,: � � . tr D�VICE MAKEJMODEL �S ZE; SERIAL�JO. � � �� I • , D�1/ICE I.00ATiQN��, i � � � �!SYSTEI41 DEV1C� � ' �RV�3: _�� /' . � ------ CH�CK VALVE CH�GK uP�VE� PR�S. DIF. I Pl�ES�, DIF I #9 , � � ACR085#1 WH�h) t�El.I�F 9Tt�AIN�R CHECK Op�N • ,.,....�.—,...�.. f , . � tEAKED( ) ' L�C�D ( ) ` � NONE ( ) ITEST BE�ORE R�PAI�ZS CLOS�D( ) GL�SED � ) �--�--p9� � ,'�gj Cl,Ni7 ( � � F1NAL TEBT � CLOS�D �LOS� Q�s�pst ! vC��p�l I — -- ....�:..V �DESCRI6E `� --- � - r��. � �..w.�.,...�..�,.. IREPAI R . � ,,, ,_.,,.��..,�,��...._,.. �..,.�.,, - � - —. -- �., ---- -- -- ��.,. � � Cer�if!cation: . � � . l hareny certii�;thst sha forepoing d�t� to be corraCt�nd thx�t the i�eted de�toe is funciioni►1G w►tt►,n the limits of ifi�atandgrds. fIR 1�; Q if�Q(y.�Ap�F't�SS;��,�U�NE A'J,�_ . BY:� .,.....:,,"��7�ft'S C�R i l�1GATIC?N#': ` , � MON #; TQ3-59�-4,�30D s�c�w,r��oF�� F�ea r�sra� F�#; 76�•595-434C I . ♦ 7625 Boone Avenue North r /� Q Phone:763.595.4300 Brooklyn Park,MN 55428 r � j, � '\�CC'�Fax:763.595.4346 1J 1Z C �ir e�ancacom E3uildiiig on Fromiaen KvFrt �� M E M 0 c�r}. 4 2Dog Date: September 18, 2008 From: Chris Fern �F�R�NO To: City of Wayzata Phone: 763-591-5572 Attn: Inspections Department Re: RPZ Report ❑Urgent �For Review ❑Please Comment ❑ Please Reply �For Your Files Attached is a copy of the RPZ test report performed at Minnetonka Center of the Arts, 2240 North Shore Drive, Wayzata, MN 55391. Thank you. Chris Fern PLGASE NOTIi:'This fax is intended only for use b��the individual or entity to which it is addressed a�id contains privileged or confidential business information the disclosure of which may bc a violation of fedcral or state law. If the reader of this message is not the intended recipient,or the employee or agent responsible for delivering the message to the intended recipient,you are hereby notified that any dissemination,distribution or copying of this communications is illegal and strictly prohibited [f you have received this communication in error,please notity us immediately by telephone at the phone number appearing at the bottom of this fax transmittal. mechanical ■electrical■systems 7625 Qoone Avenue North I Brooklyn Park,MN 55428 I p:763.595.4300 I f:763.595.4346 I www.eganco.com \n Y(6rrruiGcc 1cLiuo-�;l'yilul Opp�n�tuc�iLr�I�.:inp(tti��rr Issued:January 2005 M • � y. ' � � 7625 Boonc AVenue North � � $rooklYn Parlc,MN 55428 � �� Ma3n'763.544-4131 � Fa�t 763.S95.h346 Ax►Egan�ompaa�r www.eganca.co»i BACKFLOW�PI�EVENTFi� TEST RFP�R.T Instruction5 t0 Certified 7esters: All information must be T ed 4r ciearl linted in b1aCk Ink S17E ADDI��SS: � 7� !(/ � /� � m /`� ��o`[�� 6(. ZIP: � OCCUPANT: /`Y�r� � ��'1 ✓�'`ff PH�NE: TEST OATE: �r'�`�� DEVICE MAK�/MOD�L: .f � SIZE: t� SEAIAL NO_ l � ��/ .. �� . DEVICE l,4CATiON: .2. �=��-� � SYSTEM DEVIC6 r �, � • ' SEFiVES: �'�i cc,�'l'"~ .. CHECK VALV� CHECK VALV�# PR�S. DIF. PRES. D!F , #� 2 . ACROSS#1 � WH�N RELIEF STRAINER CHECK OPEN L�AKED ( ) �EAKED ( ) NONE EST BEFORE REPAIRS CLOS�D ( ) CLOSED ( ) � .—�S� ^ps� CLND ( ) . FIIVAL T�ST CLOS�D -'�� CLOSE� "� psi �"-' psi 17ESCRISE REPAIR Certification: � I hereby cert�fy that the foregoing date to be correct and that the tested device is functioning within the limits of the standards. FIRM NAME: EGAN MECHANICAL CONTRACTORS ADDRESS: 7625 BOONE AVE_ NO. gy.- TESTER'S CERTIFiCATION #�� PHONE #: 763-595-4300 Egaa Compa[e3es, �nc. FAX#k: 763-595-4346 SIGNA7URE OF C�TIFIED YESTCR Egan Mechanica! ( Egan-MeKav biectrical � Nietz Electric, Inc. ( Eoan AutomatAon � lnterGad I �g� Servfcc An A1�irmative ACYron/�qual Qpporr��ain��nap1�>ver BZ/90 3�Jvc NG'�0� 31t�Q 558Z�9_�9� ?S �0� 800'f8�l8E, 7625 Boone Avenue North E GA N Phone: 763.595.4300 Broolc,'�;n Pai°K,MN 55428 Fax: 763.595.4346 tivlvw.eganco.com Buifding on Promieee Kept Date: August 20, 2012 From: Chris Fern To: City of Orono Phone: (763) 591-5572 Attn: Inspections Re: RPZ report ❑Urgent �For Review ❑Please Comment ❑ Please Reply �For Your Files Attached is the RPZ test report for the Minnetonka Center for the Arts located at 2240 North Shore Drive. Please feel free to contact me at (763) 591-5572 or cmfern(a�eganco.com if you have any questions or concerns. Thank you, Chris RFc��v� Q�� Z� Q ci�,o� Z�1? �R�NO PLEASE NOTE:This fax is intended only for use by the individual or entiry to which it is addressed and contains privileged or confidential business information the disclosure of which may be a violation of federal or state law. If the reader of this message is not the intended recipient,or the employee or agent responsible for delivering the message to the intended recipient,you aze hereby notified that any dissemination,distribution or copying of this communications is illegal and strictly prohibited. If you have received this communication in enor,please notify us immediately by telephone at the phone number appeazing at the bottom of this fax transmittal. mechanical■electrical■systems 7625 Boone Avenue North I Brooklyn Park,MN 55428 I p:763.595.4300 I f:763.595.4346 I www.eganco.com .�n ai�Grmsticc.�ctiau/Equal Upportunih�Emplay.ci. Revised:July 2010 08/15/2012 05:25 7637672855 DALE BOCAN PAGE 03106 � :,�.. , r � , � . ,'Jlt�..�^�� . � . .�..... er;t6t,�en P am,t�W Kryr--^° ' � / . B�1 CrfCFL O W PRE�fEN7`E'R TES 7`REPOR T ;;i �; 1•=.`�� i�lstructions to Certified Testers: At(fnformation must ba T ed or clear rinted in btack ink SIT�ADDRESS: p� �� /+ �/�; ZIP:�� / OCCU�ANT�Jf'�,� ,C, � PHONE: TEST DA�F�; �l —^�/z_ �i oEV�cE MAK�MODEL: G S rn S1zE: � SERlAL NO_ / � f7EVICE LOCATION: � SYSTEM DEVICE SERVES_ {��.. � C� � � CHECK VALVE CHECK VALVE# PRES_ DfF. 1'RES. DtF #1 . z ACROSS#1 WNEN RELfEF STRAINER CHECK OPEN �ST BEFORE REPAlRS ��D ( j �-�KED ( ) NONE f� CLO5ED ( ) C�OSED( ) —�---PS� ----Qss CLND ( ) .� FENAL TEST CLOSE CLOSED �,�psi ��p5j 7. DESCRIBE • REPAIR CerEifica�tio�: � . 1 hereby certify that•the fo�egoing date to be correct and Ehaf the tested device is Functioning within!he lirnits of the standards. FIR, AM : EGAN C4MPA�NY ADDRESS: 7625�BOONE AVE. N�. � BR KE.YP! PARK MN 55428 B : _ -- T�STER'S CERTIFICATI�PV# 0�$778BF PHONE#; �,$�;,��9�-430C1 SIGNnzvRE oF CERZIFlEO't�STFx FAX#: 763-595-4346 : , . � 7625 Boone Avenue North E GA N Phone: 763.595.4300 Brooklyn Park,MN 55428 Fax: 763.595.4346 x�ria�.eQanco.com Buildinq on F'romieee Kept Date: September 26, 2013 From: Chris Fern To: City of Orono Phone: (763) 591-5572 Attn: Inspections Re: RPZ test Fax: ❑Urgent �For Review ❑Please Comment ❑ Please Reply �For Your Files Attached is the RPZ test report for the Minnetonka Center for the Arts located at 2240 North Shore drive in Wayzata. Please feel free to contact me at (763) 591-5572 or cmfern(a�eqanco.com if you have any questions or concerns. Thank you, RECEIVED Chris '�r P '� 0 2013 CITY OF ORONd PLEASE NOTE:This fax is intended only for use by the individual or entity to which it is addressed and contains privileged or confidential business infonnation the disclosure of which may be a violation of federal or state law. If the reader of this message is not the intended recipient,or the employee or agent responsible for delivering the message to the intended recipient,you are hereby notified that any dissemination,distribution or copying of this communica[ions is illegal and strictly prohibited. If you have received[his communication in error,please notify us immediately by telephone at the phone number appearing at the bottom of this fax transmittal. mechanical■electrical■systems 7625 Boone Avenue North I Brooklyn Park,MN 55428 I p:763.595.4300 I f:763.595.4346 I www.eganco.com :�n.-�ffirma�i�c Actiun/Equal Opportunih ICmpluccr Revised:July 2010 � � 09/25/2013 01:38 7637672855 DALE BOCAN PAGE 01/01 � �� t? O � — c� �f' Z �,�,e;.,��.,��,�......I C7�t rf'S F-�� Oh D. BACKFLOW PREV,ENTER TEST REPORT �nstn.�cGons to Certiflgd Testers: All informaBon mWt beT ed or clear� rinted in black ink SITE AODRESS: �� / 21P: ,• �f OCCUPANT; ,:' �� HONE: , . TEST DAT�. — ,,� -�.� DEVICE MAKE/MODEL: l�� s 9 �' zE: SERIAI.NO. � S DEVICE LOCATION: /Y SYSTEM DEVICE / SERVES� �1�cJ�.,p, . CHECK VALVE CHECK VAI.,VE# PRES.DIF. PRES.DIF #1 z ACROSS#1 WHEN RELIEF STRAINER CHECK OPEN EST BEFORE REPAIRS ��KED( ) LEAKEO( ) CI.OSED ( ) CLOSED( ) �..PS� ,_ps� NONE CLND ) FINA�TEST C�OSED � LOSE 4�si �•v�- � �'^ DESCRIBE . REPAIR "� Certification: I hereby certify that the foregoing date to be correct and that the tested device is functioning within the Ilmits of the Standards. FIR ME; AN COMPANY ADDRESS: 7625 BOONE AVE. NO. BROOKLYN PARK M 55428 S � � TEST�R'S CERTIFICATION# PHONE#: 763-595-4300 icw�rur�� F CE(�'t�FIED 7E$'fER F�/�#: 763-595-4346 i i �