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Park West CC(02)-LR130502 CHECK ONE: IRRIGATION DOMESTIC FIRELINE r BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: Co 11 t\ PWS I.D. LOCATION OF SERVICE: O`-1 A:r Li.. b. The backflow prevention assembly detailed below has been tested and maintained as required by TCEQ regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY V Reducal Pressure Principle ❑ Pressure Vacuum Breaker Double Check Valve ❑ Atmosphere Vacuum Breaker Manufacturer VD kklic Size /SN Model Number 101 \e�P Located At 5t. Co'l ' 4 rorriti :^VP444 Serial Number 111461 REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Check Valve Assembly 1st Check 2nd Check /Opened Valve _ Air Inlet _ Check.Valve Initial Test DC-Closed Closed Tight Rf Opened at Opened at psid Tight !e Leaked ❑ psid _____psid RP- � _____psid_____psid.6 osid VI% Leaked ❑ 1'1 Did not Open ❑ Leaked ❑ Repairs and Materials Used Test After DC-Closed Closed Tight ❑ Opened at Opened at psid Repair Tight ❑ osid ____psid RP •sid The above is certified to be true. Firm Name Al 1.4111 Certified Tester Firm Address L(U t.,i.L. vl.va 1� Cert. Testa No. 1�©0(4`11U Date S H 1; AA•VO* Irf X4(1 Gauge # O(00111Y4 Date last accuracy tested 1 tk '2 White- Customer's Copy Yellow - City Copy Pink - Tester's Copy CHECK ONE: IRRIGATION / DOMESTIC FIRELINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: .A.41 o ' Cli f PWS I.D. # LOCATION OF SERVICE: 004 A:r \;‘,....... b3-. The backflow prevention assembly detailed below has been tested and maintained as required by TCEQ regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY cyReduced Pressure Principle ❑ Pressure Vacuum Breaker Double Check Valve ❑ Atmosphere Vacuum Breaker Manufacturer \PA Size 2° Model Number 00'1 ■\ Located At 5E c.pur A pr , 14,- A04 Serial Number A0412it REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Check Valve Assembly 1st Check 2nd Check /Relief Valve _ Mr Inlet Check Valve Initial Test DC-Closed Closed Tight PI s _ Opened at Opened at psid Tight Leaked ❑ psid __psid IIh55 RP- �.1 psid � � Leaked ❑ � Did not Open ❑ Leaked ❑ Repairs and Materials Used Test After DC-Closed Closed Tight ❑ Opened at Opened at ____psid Repair Tight ❑ __,psid _psid RP .sid The above is ' ed to be true. Firm Name \ j\ Certified Tester MYkr VANIRA Firm Address 4S4r6 A,4 "1.,.. \) o . Cert. Tester No./1) tusk(,, Date S 2 i 3 . \lij Ti —WI* Gauge # 0(007 TIN Date last accuracy tested 1 Itt 11 White - Customer's Copy Yellow - City Copy Pink - Tester's Copy CHECK ONE: IRRIGATION DOMESTIC FIRELINE / BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: 0 e' CO `1 PWS I.D. # LOCATION OF SERVICE: a0'4 A:r \,:iU ' ,,r. The backflow prevention assembly detailed below has been tested and maintained as required by TCEQ regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY V Reduced Pressure Principle ❑ Pressure Vacuum Breaker Double Check Valve ❑ Atmosphere Vacuum Breaker Manufacturer \)3141 Size 3/4 Model Number 00"1 Located At a C...., a 71411 :v, \)4.11- Serial Number 1 t• krrta REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Check Valve Assembly 1st Check 2nd Check Relief Valve Air Inlet Check.Valve Initial Test DC-Closed /Closed Tight Opened at Opened at nsid iY114i Tight RP- Leaked ❑ psid _,psid RP- l.y nsid Leaked ❑ 1.4 Did not Open ❑ Leaked ❑ Repairs and Materials Used Test After DC-Closed Closed Tight ❑ Opened at Opened at p sid Repair Tight ❑ _ psid _,psid RP .sid The above is certified to be true. Finn Name NI\ LS\* Certified Tester ...at. .A. Firm Address 9% .h V L Cert. Tester No.\'0014-1lV Date 2 .\k0b-r\%,■ liqq Gauge # O(2,011'1tet Date last accuracy tested 1 ite t2 White - Customer's Copy Yellow - City Copy Pink -Tester's Copy