HomeMy WebLinkAboutPLIRR2018-3950NOV 5 2018
IRRIGATION SYSTEM CHECKLIST
Installation Completion Date:
Address:
The following items have been provided and explained to the irrigation system owner or system owner's
representative.
erg: Manufacturer's manual for the controller
g-Seasonal watering schedule
z List of components that require maintenance and the recommended frequency of maintenance is
attached
permanent sticker has been attached to the controller indicating the warranty period for the irrigation
system and contact information
'^As -built plans indicating the actual installation and components of the system
k] Location and operation of the isol 'on valve
! /t. �4AA
Irrigation stem owner/representati� Date
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 it has been installed
according to the Irrigation Plan and is properly adjusted for the most efficient application of water at this
time.
Irrigat/
Irrigation Technician
/% IZ
Date
Date
Irrigation in Texas is regulated by the Texas Commission on Environmental Quality (TCEQ) (MC-178), P.O. Box
13087, Austin, Texas 78711-3087. TCEQ s web site is: www.tcea.state.tcus.
Ir,iW. or Seal
A� JOHN P� HOFER �.
2.853 s
0
G op 4 O
Sprinklers & Repair Co.
June 2014 Page 5
NOV 5 2018
CITY OF GRAPEVINE
BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT
NAME OF PWS: GRAPEVINE ANNUAL TEST
IRRIGATION
-i--
PWS I.D.# 2200013 OTHER
NAME OF BUSINESS WHERE DEVICE IS LOCATED:
ADDRESS OF SITE SERVICED:t-•-f--
PLUMBING PERMIT IF APPLICABLE: # TESTER LICENSE NUMBER: /310 L%VijCu EXPIRES: / Z%—/ G rf
— Zc) Z
DATE OF LAST TEST GAUGE CALIBRATION: 3 - Z'7 — l p
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
REDUCED PRESSURE PRINCIPLE _ PRESSURE VACUUM BREAKER
4/60UBLE CHECK / _ ATMOSPHERE VACUUM BREAKER
MANUFACTURER: %iI° ,rI ��1 / JL%. SIZE:
MODEL: �� s // SERIAL NUMBER:
PHYSICAL LOCATION OF METER:
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER
DOUBLE CHECK VALVE
ASSEMBLY AIR INLET CHECK VALVE
1IT CHECK 2"n CHECK RELIEF VALVE
DC- osed Ti CloseI Open at psid _ psid
—�
Initial _RP psid* Opened at Did not open Leaked
Test -21 2 CO
Leaked Leaked — psid
Repair
Materials
Used
Test DC -Closed Tight Opened at Opened at
After Closed Tight _ psid
Repair _ RP psid _ psid _ psid
The above is certified to be true
TESTERS FIRM NAME:
ADDRESS: /(f>/ d/ ,S1Ja,�i y°` CITY/STATE/ZIP: �lp- I '"V 71jt/�
(�17(p�(p
DATE: /�- /d PHONE NUMBER: &1;7) �t3'�ko 7 7
PRINT NAME: J-0JI14 hf34 eW� SIGNATURE:
/111
DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FO INSPECTION AT (817) 410-3010
CQO II M E-114'le I.AlG-1\Tem 1 Pgrp��.i-..ellC Q&1CKPL.:�TE9TERREGISTF TIONeoc
111, iC1 Re 410.1'W,:,lG