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2016_0819 C�iECi� �NE: IRRIGATION DOMESTIC FIRELINE� BACKFLOW PREVENTION ASSEMBLY TEST AND hiAINTENANCE REPORT NAME OF PWS: , PWS I.D. � LOCATION OF SERVICE: Co3 �\ �o �o�i o� �—N. �,��L�I�c. i7 -�r'C�1� 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 ASSIIviBLY ❑ Rcducrd Pressure Principle ❑ Pressurc Vaczn�Brcakcr '� Double Chcck Valve ❑ Atmosphcra Vacuum Brcaker �� Manufac�er ��.a� �, Size Model N�ber �'�� C �lA Located At �� v A h1�3 Serial Nimmber ��'� �� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Dvubie Checi�c Valve Assembly lst Chetk 2ad Chec1: Relief VaIve Air Inlet Checit Valve Inival Tcst DC-Closcd Closed Ti;ht o Opcaed at Opened at �sid „1� ~�� R� Sid o Lcal:r.d o �sid nsid —P L,caked ❑ Did not Opca O Lcak�d ❑ �� 1� `r�c�l' and Materials C\aS�� Used Test ARer DC-Closcd Closed Ti,pht ❑ Opencd at Opcned at nsid Rtpair Ti�t o �sid vsid RP sid Tl�e above is cu-tifie�w be true. Firm Name�;r e-��,��S��c�r L��,e��Certified Testc ��T��o S Fum Addr�ss2�� t�.�� Ccrt. Testc No�P��► Date�S -1�1- �.le Gauge #O �c>�O a a-"�, Date last accuracy tested �-4---1110-��o White - (`nstnmer's Co�v Yellow - Citv Co�y Pink-Tester`s Copy C�iEC� �NE: IRRIGATION DOMESTIC FLR�ET.TNg �y BACI�'LOLV PREVENTION ASSEMBLY'TEST AND MAINTENANCE REPOR3' NAME OF PWS: � � PWS I.D. � LOCATION OF SERVIC�: �3 '\ ��. �o��A� �—N. C�(��L� 1.��c. �7�('�l�j 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 ASSEEMBLY ❑ Rcduc�d Pressure Princigle o Pressurc Vacui�Brcakzr � Double Cher,i�Valve ❑ Atmosphcre Vacuum Breaker l , Mauufaci�er .�►.j+'�S Size l`l` Modei N�ber �� 1(�'1 � Loca�ed At -1-N1 �1 p v.t-}+ W� 3�7t`�� Serial N�mmbcr � "�� .�^� Q REDUCED PRESSURE PRINC�LE ASSEMBLY PRESSURE VACUUM BREAI�R Dvuble Cher�c Valve Assembly lst Checl: 2nd Checl: Re;ief Valve :�ir Inlet Cher�c Valve Inirial�cst DC-Closcd a'�� Closed Ti;ht � Opcncd at Opened at asid r`��l� Ti�t � Lea�;cd ❑ ;�sid Dsid RP-�sid L � p 5 S Lcaked o � ' t Did not Opcn ❑ Leal:�d o �P� and Matcrials Uscd Tcst ARcr DC-Closed Closcd Tight ❑ Opcne�at Opmcd at nsid Rcpair Ti�it ❑ nsid osid R.P sid The above is ccrtificd to be t�vc. Firm Name�;�'�-��S:p�c.}��r�,e��Certifie�Tatc �,��1�� o S Firm Addrass�-� W•�� c«t. r�N�� 3� D� '� �auge # 43�5 o aa3 Date last accuracy tested �-�\p-�(� Wt�itP - 6'»�tnmer's Cc��v Yellow - Citv C�� Fink- T�st�r's CopY C�iEC� �NE: LR.RIGATION DOMESTIC � ��Jg BACI�F'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REpORT NAME OF PWS: � PWS I.D. � LOCATION OF SERVICE: �?3 A\ �-. �o`i o� �—N. C�C�, n�L� 1 k.. Y"� ('�l�l 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 ❑ Rcduc�Press�se Principle ❑ Fressurc Vaczn�Brcakcr � Double Check Valve ❑ Aunos�hcrc Vacu�BreaL-ar Manufacturer �� w�7a\a� Size � Model N�mmber �� Located At '��`c��D j��j Serial Nimmba � �� L��41 REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Doubie Chec��%alve Assemblp lst C3ec�: 2nd Chetl: ��f Valve 4ir Inlet C3ecic Vaive Initial?at DC-Closcd 3 •� Closed Ti;ht �, Opcue�at Opene�at osid _1�_� T'i�t � Leal:ed � :�sid ,�sid RP-_psid Q� �p,s Lcaked ❑ �' Did not Opcn � L,eaIccd 0 �� and Mataials Uscd Test ARcr DC-Close� Ciesed Ti.,,pht ❑ Opcncd at Opcacd at osid Rcpair ?i�it ❑ �sid �sid R.P sid Tbe above is ccrti.fiad to be true. Firm Name��e=��-,�r`S�p�e�r��n,e��Certifie�Tata ��v� �� a S Firm Addr�css o�.�1 W• G U� Cat Tata No"��v\�ao�CQ.� Date Ss -��l_� Gauge # o �,v�o aa3 Date last accuracy tested �-Z)lp-�(� iNi�itp - C',actc,meris C��v Yellow - CitV Co�v Pink - Tester's Copy C�iEC� �NE: IRRIGATION� DOMESTIC g��g BACI�'LOW PREVENTIDN ASSEMBLY TEST AND MAIlVTENANC�REpORT NAME OF PWS: � PWS I.D.� LOCATION OF SERVICE: �.03 '\ �., �o`�o� �—N �L�r��t��c. �")�'C)I�j 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 ASSEI�iBLY ❑ Rcdur„�Press-�e Principle ❑ Pressurc Vacui�Brcakcr � Double Chec.�Valve � Amzosphere Vacuum Breakcr >> Manufact�er �� v Size _� Modei N�ber ��J � Located At � Serial N�mmbcr �f o��C� REDUCED PRESSURE PRINCIPLE ASSEhiBLY PRESSURE VACUUM BREAI�R Doub{e Che�c�%alve Assembly lst Checl: ?nd Checi: Re�ief VaIve :4ir Inlet Checl�c Valve Ininal?est DC-Closodo��9 Closed Ti;ht � Opcned at Opened at �sid �,,� ' Ti�t �j Lcaked � Dsid osid RP-_psid � Lcaked ❑ � '� Did not Opcn o LeaI;�d ❑ �P� and Matcrials Used Test Af�rs DC-Closcd Closcd Ti,ht ❑ Opencd at Opcned at esid Rcpair Ti�t ❑ nsid vsid RP sid Tlie above is cezrified to be true. Firm Name�;�e=��.�,�°��P�c}�,,�r�,eh�Certified Testa t�� o� Firm AddrGs..s�� J• `��_L`i.� Ccrt Tata No"�'��3 a��C D� — ^\ Gauge #O3 p�o a;Z3 Date lest accuracy tested �-p�� TN�31tP - C',IICtAR1P_PiS COS39 Yellow - CitY Co��1 Pia11c - Test�r's Copy