The URL can be used to link to this page

2015_0210 (:�[I:CK �1+�k�n � � � IItR1GATION llOMESTIC � �'BR�I.INE �ACK�'L,OP,�V PREVEN'd'ION ASSEMBLI'TES'T ANA 14iA1rNTENAI�1'CE REPQRT NAME OF PWS: el, "�C . �S�i 5 �WS I.D. # LOCATTON OF SERVICE: f� �ivi dfnc� c�� . �i'Q�l {Y• �5�1� The backflow pr�vention assembiy detailcd below has been t�sted and �z�aintaii�ed as required by ��CE�� regulations and is cc�lilied to be operating �vithin acceptable p�rameters. TYPE OF ASSEMBLY � Retiucrd Pressure Principle � Pressure Vacu�Breaker ❑ Doublc Check Valvc C A�osphen Vacuum Breal:er Manufactiu�er W��`�S Sizc �` Model Iv�ber �'S L.ocaud At ��SP� I'C�U►�'� Scrial Nt�ber L�� RED�JCED PRESSURE PAINCIPLE ASSEMBLY + PRESSL�TE VACUUM BRE.4I�'ER Double Check v zlve Assembly � r Ist Chec1: 2nd Checl: Relief Valve :�r Iniet Checic Valve Inival Test i DC-Closed Closed Ti;ht �i Opeaed at Opened at _osid Ti�t 7� Leal:ed� ❑ �•��— psid �sid �� RP- �'S nsid �� D�d noc Oprn ❑ I,ea�;ed ❑ �� i and MataiaLs , � ; Used � � Tcst After DGClosed C�Qsed Tight ❑ Opencd at �,ime�at �sid Rcpair Tight ❑ nsid �sid RP sid 'Y'he above is�fied to be sruc. Fbrm�iamc �'�l (es� cer�fioa Tuccr wrll�a►'� oR�v� Firm Aadress �� /�la fi..[��LY uiPW �n , cert resta No. �(bo(6tr� �ace 2-� �� • 1n1�� '�c• `7�.0 U � caauge � C?�13�6(S vate last aecuracy 4ested I�- (� - j� �Vt�ite - �,u�torn�r�s Cv�y Xellow -- C:ity C;Upy Pink - Tester's Capy I