Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Creekview II 1B-CS000608
FAX COVER SHEET NA/s~ Of PWS: PWS LD. ~ LOCATIC:%; OF The I~cU~ow preve~o~ a~mnbly de~lcd below has bom ~ aa~ ~ a~ ~ ~ Tt~C¢ mguba~ end is certified m be opcr~Ull wilbin ~tblc ptmneta3. Maaufa~o~ '~ Mod~l N~,b~ ~rial N~mi~r Double ~ V~lve REDUCED PRI~$$L'R.~ PRINCI~LI~ ASSEbt~BLY P~SS~ VA~ B~R TE~ ~x~e i~ m~i~l to be true. Wtdte -Ct :stomer's Copy Yellow - City C~q)y Pink - Testet's Copy C/IE~K ONg~ IRRIGATION I)OMEb'TIC FIREhlNE V/ PWS i.D, # _ LOCATiON OF SEi~.ViCE: ~'~D2. ~ ~_X~,,.IrT'~ ~ and b =="~ ~ b~ OlX:r'ating within ar.c~table par~me~'s. TYPE OF ,aSSEMBLY M~ ~ ~ S ~ Pr~ssu~ Vammm Brm~zr Atmospher~ Vacuum Breaker PRESSURE PRINCIPLE ASSEM~BLY [ PRESSURE VACI.R.~ BREAKER REDUCED ~ ~s~- Ikmble Oee. k Valve Assem~y l~t ~eck [ 2nd Cl~Jc l~lief VIlve Air inlet Cheek Valve InilialT_a~t DC.Closed : Closed Ti~t = Ope=ed at Openeg ~) psid · a L=~I '~ psid psid Used Te~ A.~er DC.Closed Clmed T~t m Ol:~med at Ol~ned at ~ , j~id R~pair Tight O I psid psid Date last aecurney tested ~hite - Cu~tomer~ Coiry Yellow - City Copy Pink - TestePs Co{)y ZO~ ZO;Hg H~IJ ,';i'L~,9~¥ ~g§~ 09,9 ZI9 '/¥*~1 ~::~.'~ 00.'90,'90 CHECK ONE: IRRIGATION DOMESTIC PIRELIRE ~ NAME OF FWS: PWS I.D. # LOCATION OF SEEVICE: BACIO~LOW PREVENTION ASSF.,~LY TEST AND MAINTENANCE REPORT Pr~ss~ Vacuum j RY. DUCED PRESSURE PRINCIPLE ASSEMRLY PRESSURE VACUUM B~R 1~ ~e~ !nd ~ ~ef V~e ~r I~ ~ V~ ~.~id U~ ~ Ti~ a ~id p~d ~ ~d White - Customer~ Copy Ye. How - Ci~ Copy Pink - TestePs Copy