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Click ‘Get Form’ to open the rpz test report in the editor.
Begin by entering the 'Name of Building, Suite Number and/or Business Name' at the top of the form. This identifies where the RPZ is located.
Fill in the 'Job Address' with the physical address of the RPZ(s). Ensure accuracy for proper documentation.
Provide details for 'Owner/Occupant or Responsible Party/Contact Person' along with their 'Contact Phone'. This information is crucial for follow-up.
Select the 'Type of Work' being performed by checking one of the options: Install, Test, Overhaul/Rebuild, or Remove.
Complete fields for 'Date Completed' and 'Last Overhaul/Rebuild Date' to maintain a record of service history.
Document device specifics such as 'Device Location in Building', 'Room #', and 'Floor #' to pinpoint where it is installed.
Fill in technical details including 'Make', 'Size', and 'Model #' of the device. This ensures compliance with standards.
Record test results for both check valves, including PSI/Diff readings and serial numbers. This data is essential for certification.
In the section provided, describe any repairs made or indicate if this installation replaces an existing device, including its serial number.
Finally, certify your information by printing your name, signing, and dating the form. Include your State Certificate Number and Company details as required.
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