HomeMy WebLinkAboutPLIRR2015-2526OCT 19 2015
CITY OF GRAPEVINE
BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT
NAME OF PWS: GRAPEVINE ANNUAL TEST
IRRIGATION
PWS I.D.# 2200013 OTHER
NAME OF BUSINESS WHERE DEVICE IS LOC
ADDRESS OF SITE SERVICED: /DSO, 11
PLUMBING PERMIT IF APPLICABLE: # _r (,I ICIL —
TESTER LICENSE NUMBER: D`-t l J EXPIRES:
DATE OF LAST TEST GAUGE CALIBRATION:
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
OUBLE CHECK —ATMOSPHERE VACUUM BREAKER
MANUFACTURER:: //``– �����K.Y✓V" SI1ZIE::
MODEL: U J SERIAL N MBER: -fit Q
PHYSICAL LOCATION OF METER71 �Y�({/�VJJ
The above is certified to be true.
TESTERS FIRM NAME:. �,�tk N fly&3
ADDRESS: �� , r/i� 0 CITYISTATEIZIP: I 77 129/
DATE: t'=J PHONE NUMBER: 3 -
PRINT NAME: C SIGNATURE;
DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FOR
==Ms 11 gaLLOCpLS-11TaApl Np sa \TCEQBACKR WTESTERREGISTFPTIDN.de
it/3NORGV.4N5, tAfi, ]JIO
AT (817) 410 -3010
- REDUCED PRESSURE PRINCIPLE ASSEMBLY
PRESSURE VACUUM BREAKER ..
DOUBLE CHECK
VALVE
ASSEMBLY
RELIEF VALVE
AIR INLET
CHECK VALVE
15T CHECK
2 N CHECK
Open at_ psid
_ paid
DC -CI ed Tight
Closed Tight
Initial
RP O<< psid
— P
'2 A
Opened at
Did not open
Leaked
Test
psid
Leaked
Leaked
_
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:. �,�tk N fly&3
ADDRESS: �� , r/i� 0 CITYISTATEIZIP: I 77 129/
DATE: t'=J PHONE NUMBER: 3 -
PRINT NAME: C SIGNATURE;
DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FOR
==Ms 11 gaLLOCpLS-11TaApl Np sa \TCEQBACKR WTESTERREGISTFPTIDN.de
it/3NORGV.4N5, tAfi, ]JIO
AT (817) 410 -3010
WARFORD IRRIGATION & LANDSCAPE, INC.
DBA SOAK -N -GROW
PO BOX 836
WHITEWRIGHT, TX 75491
OFFICE 903 - 364 -2634
Date: 10/16/15
FAX 903 - 364 -2912
The irrigation system installed at 1058 Lavon Dr has been installed with all
applicable State and local laws, ordinances, rules, regulations and 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.
Sincerely,
l� W
Kurt Warf0
.� '9s ►r
LIA . KWgRFORD
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