Loading...
2015_1112 (2) C�IECK �NE: IRRIGATION DOMESTIC FIRELINE BACT{FLOW PREVENTION ASSEMBLY TEST AND MAINI'ENANCE REPORT NAME OF PWS: �.r'?�I G' � �c? -�,J�1J PWS I.D. # LOCATION OF SERVICE: �� '�� Y/zr����' The backllo���prevention assembly detailed be(o��� has been tested and maintained as required by TCEQ rcgulations and is certified to be operating�vithin acceptable parameters. TYPE OF ASSEMBLY ❑ Rcduc.�Pressure Priaciple o Pressure Vacutmi Breaker � ee�"-T�:� ❑ Am�osphare Vacuum Brea�:er C �J/� Maaufactc�er la c-r -s � Size c� Model Ntmiber 77'J Located At v�� +�' Scrial N�bcr � �ra �� 7 3 REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�CUiJM BREAI�R Doubie Check�alve Assembty lst Chec.i: ?nd Chec{: Retief Valve Air Inlet Check Valve Inirial Test DGClosed Closed Ti,�ht 1�' Opened at Opened at nsid Ti�t � z� ,� Leal:ed . ❑ _nsid nsid �r.L�`� RP-wpsid �-� Leai:ed o Did not Opea o L,eaked o �P� and Mataials Used Test Af�es DGClosed Closed Tight o Optned at Opeaed at __nsid Repair Tighi o _osid _nsid R.P sid The above is certi6ed w be uve. y Y� Firm Name ,�c�'��� r-�,�L c«tis�a r� ������ w��.�_� Firm Address ��� '�t�K �7 S 7 Cert.Testa No. o r?c�9�f J�' Date � I ,' i,JeX' T� 7�/G.S Gauge # p^ �,�+ � � .y llate last accuracy tested 3/�� White - Customer's Copy Yellow - City Copy Pink-Tester's Copy ��o�iil�;rt"I�� �;_;�;�] iti;,o 11��.�i"'C��5�����'��i,��'" �r, � '�• ��� r �� U,�.aG��� .�°li'rc� I: It� 1. :;.�n��I,� 1�;s�l�,�a�.�^�,���� Ii"l'�`",����:��i'"� 'C��'��'��f'�j...�:;�3�f.`,, '�.�. �„ /;�,�. ��-a�.a ,� ..,. , r ti�'�;�,.�, ��1��. �"����;:��y��`�%�,: �;,��'� e"��°` �'�����'IF�IE�;I� — —.,�.���_�-- � ��r��.��. � ��_� I�C���s �,��.�.��� �����:������;: g s I /v, /�1�-c►4��2 b�i��.��_.�_�..�� __ �� 6���� �r�a�a�i�� ��c��ab�;� ��r�a�� ��:���- r� ��;:: �;::���'. ���:�^ �ui��:��.�a�.:a � ���ar� t�o li°�+:�.�� ��:��i�tt��d i� ' ���C��op�����t���;��ai�fl�����c;�~.:. ��������k.� . � ��c��',�;s������&� � ��9��:�T��r�;� - �as���Ch���I�$�re � ,���a��ab�-c:�I�;c�n�z�;�a����:�- �����f��x� l�►'►'ILs �� y „ �������� .3l,�vSs ���g � � s�;���b� /Y�ar � ��.�..���,,.�m. �.� �._,�,__�.� , �������ss� r�����:�����.�% � ��ss�a-� ��cuv����. � Y � D�a�bte Ch��%�vc�iss�,bly �, q 9 1 st��c3: 2�d�ec�. � ��li��"��a�� �.4s���a➢�s Cbeek`I�v� �i���"� DC-Cl�s� Closed Ti�� (>p�^�,�e Opc��d�e �si� C Ta_ �j � L�ed2,�� ��si� �sid P�J� �- ' s��i ✓ ; � . �:�a �a��t�� o �:�a � a�d � i � � �tac�xia,� � � � ZJsed Te� DC-Cl�� �9wsa�.Te�� � C)peue�d�c �il�� c�sid R��ia' �°ighe ❑ ' ; ��id � ���� �P si� � � ��a���r�a���.¢���, � �T _/�Z� ��r �.� �° �ed�'�: ' _ c1 �� ��� �� L2ub r �j /?i( �16� ��. ��r����. Y Y7 ��c�� /�` �' w�yP,l�- ��zHg ����4A # �S�i�� 1 li���a� �a�� ���a��a��� ��A:��� i—���/��� ��a��c� �-� ��'tt����raa�r�"� Q���a� �i�A����� �- liQRt'i�w ��c�a� I���;�� _,.°�"���r°�� ��aa�e� << 1�1,1���:�f� 'i;�. ���;�I"a]���a � ll � � ��) /� Iy [ r _ 1 , 1 I�,I1"�z14:olf�1��.k��.AY9�1 y�N�11i� A�a,i`^RI��Yi�O !t"��1 � :!an��"��i� ia?��1.$� '� �.�°�S' S�`� �+�,���.,A�..... r\�.h����»����.'..d�=`,�..�j,\i; ,s.�.� �i f,v � i. %,� %.a h� �. ;� ��. f'Mz w,•Ai,�.� a. . .::A�t��1�..,�`., �� ����'�::��'���1'�,: �"��'`Y a�'1�` �'c����IP'IE�,�� ����.�. � ��� �� ��x� s �._e»��w� ����.�������:������: g�� - ffir�/�-c�►�.c�/��_.�� _.___ ___._.�._�._�_� `�� �`���� p�:.�,��a�� ����b�� �e�� ��:�e�� f�.� �r� 4�a��A �k�:a �a��iAa� � �a�� t�`�% 1`i�a��� �� ������s ' ���Ca�op�a�a�a�;�i����e:��r��fl��S�v'��:�:.. �"�������t.,��-Y��Y° �c�����.��� � �a��� � �a�_as��,�1����'s '� �au�&�C���;�T��r� � .�t����iah�s���J��.�iaz��x��au�� N A�i�aif'����z C,.S �a� � ������� �1UI�a ���g .�� �va►v� � s����� �l L�aLO y . s.�._R�r , ��u����ssu� P�N��,�:�s����,� � ��ssv�, v�cw���R � D�ubie�lb�cic�%�ve�ss��Ey � � 9 � � 4 � lst C�er.i: ,.nd1��c�: ��li���%��r� ���i�ilee Check��lv� �i���'� DC-Cl��e� Clos�ei°�i�h� �*�,�e Op��d a� �sid �' L� Ti_ � I L - � _��a�i� � :�sid l �1�J/ �. i� si�i i � ; L,�al:e� � � �ud�oc�� � � Y.�l:ed � . �� ����. i a�d � ; �ac�ria� � � �Jsed T� DC-CY�� ����d.Tn�fia� � ppeac��2 �.�e �sid ��r �°i�he ❑ ra�i� ��id � sic� n �a�a�bav�� . �����, � ����'2r� ���� �,►�2� I �s ?" _,�.� � � .�a� �� . ����.� �?,�s"�j ✓�� �1� ���. ������. �a �K� ���� �/3'�(v �, �� � ������ � � � ( ����4'° ��. ���6�a`8A(`� ��a��t�6�-1 _Q ��J _,_.. �'���c� µ clra��Q�r�a�^�wa� Q�'a���� 5 �,����t�.a �, �„�R� �:;c�� ls���� -..°�°a_�&��W� ��a�a��