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Home My WebLink AboutPLIRR2017-3229SPRINKLER SYSTEMS & LANDSCAPING I M-A Bedford Rd. - Bedford. TX 76021. 617-540-1%9 www. midctesnption. com FINAL CHECK LIST DATE: cI PERMIT#: 0-'37-7-9 ADDRESS: 7,110 Ckwn-, In 1. FINAL WALK THROUGH TO EXPLAIN THE OPERATION OF THE SYSTEM MAINTENANCE CHECK LIST: OOT,O 6 2G4 A. THE MANUFACTURER'S MANUAL FOR THE AUTOMATIC CONTROLLER B. A SEASONAL (SPRING, SUMMER, FALL, WINTER) WATERING SCHEDULE C. A LIST OF COMPONENTS THAT REQUIRE MAINTANANCE AND RECOMMENDED FREQUENCY FOR SERVICE. #1 CHECK AND CLEAN NOZZLE'S MONTHLY FOR CORRECT COVERAGE #2 TEST RAIN/FREEZE SENSOR EVERY MONTH #3 SERVICE AND CLEAN Y STRAINER YEARLY 3. THIS IRRIGATION SYSTEM HAS BEEN INSTALLED IN ACCORDANCE WITH ALL APPLICABLE STATE AND LOCAL LAWS, ORDINANCES, RULES, REGULATIONS OR ORDERS, I HAVE TESTED THE SYSTEM AND DETERMINED THAT IS HAS BEEN INSTALLED ACCORDING TO THE IRRIGATION PLAN AND IS PROPERLY ADJUSTED FOR THE EFFICIENT OF WATER AT THIS TIME 4. PERMANENT STICKER: COMPANY AND WARRANTY DATES 5. IRRIGATION PLAN TO OWNER OWNER OR OWNER'S REPRESENTATIVE MID -CITIES IRRIGATION, IN . REPRESENTATIVE Texas Commission on Environmental Quality BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT The following form must be completed for each assembly tested. A signed and dated original must be submitted to the public water supplier for recordkeeping *purposes: � NAME OF PWS: I :�N of l�co�e �l;vu2: T 45 PWS 1D#: B PWS MAILING ADDRESS:, /✓�� Sf PWS CONTACT PERSON: �ADDRESS OFSERVICE: �.� C7�ap¢t�:ne: `� The backflow prevention assembly detailed below has been tested and maintained as required by commission regulations and is certified to be operating within acceptable parameters. TYPE OF BACOLOW PREVENTION ASSEMBLY (BPA): ❑ Reduced Pressure Principle (RPBA) I ❑ Reduced Pressure Principle -Detector (RPBA-D) Type 11 El .X Double Check Valve (DCVA) ❑ Double Check -Detector (DCVA-D) Type 11 ❑, 0 Pressure Vacuum Breaker (PVB) ❑ Spill -Resistant Pressure Vacuum Breaker (SVB) Manufacturer: Main: I; (nS Bypass: Size: Main: /�' Bypass: Model Number: Main: Bypass: BPA Location: ro,Vv - vear f. V,,Snf &Jk Serial Number: Main: 9775/rj Bypass: I BPA Serves- qQ per, 0 Reason for test: I New ❑ I Existing X' Replacement ❑ Old Model/Serial # Is the assembly installed in accordance with manu acturer recommendations and/or local codes? Is the assembly installed on a non -potable water supply (auxiliary)? TEST RESULT Reduced Pressure Principle Assembly (RPBA) PASS N1 I DCVA - Relief Valve FAIL ❑ I I" Check 12nd Check*** Initial Test Held at . Held at psid psid Opened at Date:/o/d/a� Closed Tight 1[ Closed Tight psid Did not Time: j,q; ) p_ Leaked ❑ Leaked ❑ open ❑ Repairs and I Main: (Materials j Used** Bypass: Test After Held at — psid Held at _ psid Re air Closed Tight Q Closed Tight ❑ (Date: Time: Type II Assembly 19 Yes ❑' No ❑ Yes I f R1 No PVB & SVB Bypass Check Air Inlet Check Valve Held at _ psid Opened at _ psid Meld at Closed Tight ❑ Did not open ❑ psid Leaked ❑ Did it fully open Leaked ❑' (Yes �❑ /No ❑l at _ 11 Held at 11 at ^ psid 11 Held at— *** 21d check: numeric_ reading required for DCVA only _ Differential pressure gauge used: Potable: 't 1 Non -Potable: ❑ Make/Model: SN Date tested for accuracy: Remarks: j Company Name: Licensed Tester Name /M (Print/Type): Company Address: 6n2.E;9'&'0-11Gt�L� %�s-% Licensed Tester Name (Signature): Company Phone #: J�35 BPAT License #j(� License Expiration Date: ja�as/a©� �_i The above is certified to be true at the time of tesC►ng. * TEST RECORDS MUST BE KEPT FOR AT LEAST THREE YEARS [30 TAC §290.46(B)l ** USE ONLY MANUFACTURER'S REPLACEMENT PARTS