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Vista Ridge 1&2-LR051025P. 02 C')IECK ONE: IRRIGATION__ DOME517r.; ! � _ PIRl3L)dN.E BACKnOW PREVEMTQN ASSEMBLY TEST AND MMNI'ENANCE REPORT NAME OF PWS PWS LD .LOCATION OF SERVICE / �I � r��AZ�•4 � Y,� Th backilow 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 Rrdueed Pressure Pnucrple o Pressure Vacuum Breaker ` Double Check Valve 0 Atmosphere Vac uum Break -or Mauufactiurr Size Makl 'N=bcr __. / r� La:arrd At s c� Serial N=bcr w.�,C.� The above is ccrttEed to be true. Firm Name L 4 4 , Z Lc'c' 7 — Certified Tamar �� `��•' E M ,i ; `, r Firma Address �'� I c K• vc �, Cent Tester No. � 'i�� j�z Date llatP- AWI FACCur8zy tested While - Customer's Copy Yellow - City Copy Pink - Tester's Copy REDUCED PRESSURE PRINCIPLE ASSEMBLY Double Check Valve Assembly lst Che t ad Relief Valve PRESSURE VACCTUhti BREAKER Air Inlet Check Valve ininal Test DC- Closed I',bt Closed Tight � Opened at Opened at w ,�psid LeaieJ sid psid R u�d _ _.... Did not Open © Le aked R -Paul _ and Materials Used Test After DC- Closed Closed Tight C7 Opened at Oprncd at psid Repau Tight a -, psid ,,,_,____,,,psid RIB sad The above is ccrttEed to be true. Firm Name L 4 4 , Z Lc'c' 7 — Certified Tamar �� `��•' E M ,i ; `, r Firma Address �'� I c K• vc �, Cent Tester No. � 'i�� j�z Date llatP- AWI FACCur8zy tested While - Customer's Copy Yellow - City Copy Pink - Tester's Copy P.03 CTIECK ONE: IR RICA TION9 .,.._._.___ DOMESTIC__�< �– FIRE L INE -- -- BACKFLOW PREVEN'T'ION ASSEMBLY TEST AND MAINTENANCE REPORT' NAME, OF PWS 0O�f a PWS I.D iO LOCATION OF S ERVI CE — j ('he 17)aLkilow prevcnnon assembly detailed below has been teste and maintained as required b re.oulat,ons and is certified to be operating within acceptable parameters M Ruluced Presswe Principle Double Check Valve Manufactzuer �/� � • ,..�F Model Number Senal Number� TYPE OF ASSETviBLY Pressure Vacu= Breaker 0 Atmosphere Vacuum Breakrr C > // Size 1 Located At We � c+1t. A41,,� r c.yl /J7f – 7£ - 1 REDUCED PR ESSURE PRINCIPLE ASSEMBLY P RESSURE VACUUM BR1rAKER trouble Check Valve Assembly 1st Check 2nd Check- Relief Valve Air Inlet Chedt Valve Lzinal Test DC- closed Tight D F Closed T ight a Leaked U Opened at sid Opened at _ _ __ __psid L ea Did not Open 0 Leaked Q Repamt J and Matmals 6 " / €c, /< Used 7 Test Al r IBC- Closed Repair Tight /, j –' x Rl'____ sad Closed Tight , / Opened at —pstd Op=od at r .,_.., - _ --p sid The above is Certified to be Uue. Firco Address i` ;55 x'1 Gauge if ?-37 c � 2 _ Canfied Testa A AeA l d, T`4f Cat Tester No. �� � � � Z. Date // I Date last accuracy tested White - custorrmer's Copy Yellow - City Copy Pink - 'jester's covy P.02 CHECK ON MCULOw PREVENTION ASSEMBLY TEST AND MAYIM -NANCE WORT NANM OF PWS Cr, / f� =- —. LOCATION OF SERVICE. The backflow prevention assembly dctailed below has been tested and maintained as required by TCEQ regulations and is certified to be operating within acceptable parameters. 0 Manuf'acnucr Model N tuber Serial N=bct Final Test R,cp= and Materials Used TYPE OF ASSENOLY Reduced Pressure prnaciPlc 0 pressure Vacu= Breaker Double Check Valve 0 Atmosphere Vacuum Brealccr Si ze _ li Located At REDUCED PRESSURE PRINCIPLE ASSEMBLY Double Check Valve Assrmbly 1st Check I 2nd C heck DC-Closed Closed Tight Tigh� Leaked Leaked O W Test After DC -Closed Rep$,ur Tight RP Did not Open o I Leaked - std CIosed Tight a (?pcncd at Opanod at .. �.... -.—p C3 ___,__,__,__psid —,.._...Psid The above is cettified to be tnic. Film Name Firm Address _ I-22 Valve PRESSURE VACUUM BREAM Air cried at Opened at � Opened �psid �. .._._....�P sid 0 L/ L Certified Tc= / 2 Cent. Tester No; Gauge # Date last accuracy tested C' ��G White - Cu.,tomer s Copy Yellow - City COPY Pink - Te rter's Copy