HomeMy WebLinkAboutPLIRR2023-003135 (3) ailey's Landscape Management, Inc.
145 Desiree Lane
Highland Village, TX 70577
Ll# 3665
Irrigation Final Inspection Sign Off
Installation completion Date: jo-io -PLI
Irrigation Contractor: David Baile;• ® 8p,ile,.'s Landsca;_:e Manaiement Inc,
Installation address: 31b
The following items have been provided and explained to the irrigation system owner, (if the
current owner is the builder, he is responsible for passing this information On to the new
homeowner when sold.)
I The manufacturer's manual for the controller,
2, A seasonal watering schedule,
3. A list of components that require maintenance and the recommended frequency of
maintenance.
4. A permanent sticker attached to the controller indicating the warranty period for the
irrigation system and installer contact information.
5. The corrected as installed design plans indicating the actual installation and
components of the system.
6. The location and operation of the isolation valve.
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Irrigation Systern Owner i`�epresentafive t
hBuiId l,(�4
Thi.,, �:Vstonn has been installps,-J in acf:ordance with all applicable state and loci,-fl iaws,
o�6M,inces, rukis, reguLitions and or orders, I hive tested ffie system �.,ind dpterrnined &,"It i �. h a s
be,en msualh:art as:.cwchng , to the irrigation lilan ��,nd is Properly idjusted p'or tho rnost 8,Jficiei-lt
?pp fir,ation t,,A vvnrer ZA thi'S OTP,
NUENNERM
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1:0-09 -
Date
:Pbaileys.landscape@verizon.net
TCEQ-20700 (Revision 04-04-2019) Page 1 of 1
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:
PWS ID#:
PWS MAILING ADDRESS:
PWS CONTACT PERSON:
ADDRESS OF SERVICE:
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 BACKFLOW PREVENTION ASSEMBLY (BPA):
☐ Reduced Pressure Principle (RPBA) ☐ Reduced Pressure Principle-Detector (RPBA-D) Type II ☐
☐ Double Check Valve (DCVA) ☐ Double Check-Detector (DCVA-D) Type II ☐
☐ Pressure Vacuum Breaker (PVB) ☐ Spill-Resistant Pressure Vacuum Breaker (SVB)
Manufacturer: Main: Bypass: Size: Main: Bypass:
Model Number: Main: Bypass: BPA Location:
Serial Number: Main: Bypass: BPA Serves:
TEST RESULT
Reduced Pressure Principle Assembly (RPBA)
Type II
Assembly PVB & SVB
PASS ☐ DCVA
Relief Valve Bypass Check Air Inlet Check Valve
FAIL ☐ 1st Check 2nd Check***
Initial Test
Date:
Time:
Held at ____ psid
Closed Tight ☐
Leaked ☐
Held at ____ psid
Closed Tight ☐
Leaked ☐
Opened at ___
psid
Did not
open ☐
Held at ____ psid
Closed Tight ☐
Leaked ☐
Opened at ____ psid
Did not open ☐
Did it fully open
(Yes ☐ /No ☐)
Held at _____
psid
Leaked ☐
Repairs and
Materials
Used**
Main:
Bypass:
Test After
Repair
Date:
Time:
Held at ____ psid
Closed Tight ☐
Held at ____ psid
Closed Tight ☐
Opened at ___
psid
Held at ____ psid
Closed
Tight ☐
Opened at ____ psid Held at _____
psid
*** 2nd check: numeric reading required for DCVA only
Differential pressure gauge used: Potable: ☐ Non-Potable: ☐
Make/Model: SN: Date tested for accuracy :
Remarks:
Company Name: Licensed Tester Name
(Print/Type):
Company Address: Licensed Tester Name (Signature):
Company Phone #: BPAT License #
License Expiration Date:
The above is certified to be true at the time of testing.
* TEST RECORDS MUST BE KEPT FOR AT LEAST THREE YEARS [30 TAC §290.46(B)]
** USE ONLY MANUFACTURER'S REPLACEMENT PARTS
Reason for test: New ☐ Existing ☐ Replacement ☐ Old Model/Serial #
Is the assembly installed in accordance with manufacturer recommendations and/or local codes? ☐ Yes ☐ No
Is the assembly installed on a non-potable water supply (auxiliary)? ☐ Yes ☐ No
Midwest 845-5 01151514
Classic Backflow, LLC
3025 Oak Meadow DrFlower Mound, TX 75028
214-535-3341
Charles Jestis
BP0016431
3/17/2024
City of Grapevine
2200013
PO Box 95014, Grapevine, TX 75099Building Inspection
07/07/2023
309 Tillery Ct
Wilkins
350
AJN2042
1"
Front
Irrigation
10/15/2023
07:00 PM
2.5 2.5