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Home My WebLink AboutSWP1997-0130 04/29/1999 08:54 8173290432 GALLAGHER PAGE 01 04-29-199B 09:34AM DML9PMENT SERVICES 191742405451@ +15864 P.01 CITY OF GRAPEVINE ` TEMPORARY ELECTRIC RELEASE Temporary, slectridty has been requested for the purpose of construction, remodel, addition or Improvement to the following described property. It Is undpraMod that this r{tisase In no w=-vilithodzes gccupongy_of the buildin a. It is further understood that this temporary relsaae is for a thirty (30) day maximum time period and the undersigned releases all claims that may occur through accidents or spoilage of any type resulting from said electric power being turned off at the and of the thirty (30) day maximum time period. Address of location of temporary electric release: STREETX STREETS L L S=1J CONTRACTOR INFORMATION NAME OF APPLICANT czAvx t ADDRESS OF APPLICANT (Qg L�r .¢U4" CITY, STATE, ZIPij TELEPHONE NUMBER f t"-7 .3711 wrwiwwwwwwrwrrrMrrrwwwwwrw•rwwr•wwwwwwrlrrww•wrrrr•rw•wrwr•rr INSPECTIONS FOR TEMPORARY POWER MUST BE REQUESTED AT 817/481-0366 �Ilrrr••wrr•wrswwre wwwr•rAFyraalFwr•rrrrrrrrrr#w•rwrrlrrr•rrrrw•w SIGNATURE PRIWTED NAME DATE 4LD 'OFFiCtAIL SIGNATURE Z(, DATE REV. tn4»S rA1WMkv-"MP TOTAL P.01 CITY OF GRAPEVINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: GRAPEVINE PWS I.D.X 2/120001113 LOCATION OF SERVICE 1 SO N a) t— �JC1Ylil�C)Vl ctc� PLUMBING PERMIT# C-7 1 00 THE BACKFLOW PREVENTION ASSEMBLY DETAILED BELOW HAS BEEN TESTED AND MAINTAINED AS REQUIRED BY TNRCC REGULATIONS AND IS CERTIFIED TO BE OPERATING WITHIN ACCEPTABLE PARAMETERS. TYPE OF ASSEMBLY _/REDUCED PP.ESSURE PRINCIPLE _ -RESSURE VACUUM BREAKER DOUBLE CHECK _ATMOSPHERE VACUUM BREAKER 11 MANUFACTURER _ A SIZE a !I MODEL 00-7 LOCATION OF METER R 1 t4e46!41 JUhy6G SERIAL NUMBER h ) 1 Reduced Pressure Principle Assembly Pressure Vacuum Breaker Double Check Valve Assembly Air Inlet Check Valve 1 at Check 2nd Check Relief Valve Open at_psid _psid Initial DC-Closed Tight_ Closed Tight_ Opened a[ Did not open_ Leaked Test RP-_psid psid Leaked Leaked Anm DC-Closed Tight_ Closed Tight__ Opened at_ Opened at_psid sid a <t RP_psi d psid —p The above is certified to be true. FIRM NAME d tilt/,n Bac 1: ((',t,1 V /'C P S✓lC TESTER'S SIGNATURE PRINT NAME �)fe\d cc� �Tc7l a, ADDRESS �V, ,, IIX Q 3(,0 ( CITY,STATE,IIZIP� �,yi I lie 1 X� ��7�Y'�� CERT. TESTER NO. Y500 7 c)0 DATE DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FOR INSPECTION AT (8171481-0366 OAFORMIBACKFLOW 9/12/96 -(�, C'j �� ISO CITY OF GRAPEVINE �� t� BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: GRAPEVINE PWS I.D.# 2200013 1 LOCATION OF SERVICE 1 � Fa i 1 Q �'�Q 2d PLUMBING PERMIT#_ 7 1( � THE BACKFLOW PREVENTION ASSEMBLY DETAILED BELOW HAS BEEN TESTED AND MAINTAINED AS REQUIRED BY TNRCC REGULATIONS AND IS CERTIFIED TO BE OPERATING WITHIN ACCEPTABLE PARAMETERS. TYPE OF ASSEMBLY _ REDUCED PRESSURE PRINCIPLE _PRESSURE VACUUM BREAKER / v DOUBLE CHECK —ATMOSPHERE VACUUM BREAKER MANUFACTURER oiis SIZE as I MODEL 00-7 pp LOCATION OF METERsO� SERIAL NUMBER G?<JO Reduced Pressure Principle Assembly Pressure Vacuum Breaker Double Check Valve Assembly Air Inlet Check Valve 1st Check 2nd Check Relief Valve Open a[_psid _psid Initial DC-Closed Tight_ Closed Tight_ Opened at_ Did not open_ Leaked Test RP-_psid psid Leaked Leaked Ttwr DC Closed Tight_ Closed Tight�_ Opened at_ Opened at_psid _psid R< an RP—Psid psid The above is certified to be true. FIRM NAME ;.S n ('�IgCdc�( (c� � y1ttCP �v\C TESTER'S SIGNATURE / PRINT NAME ADDRESS R0 ,i30X *.:19 �(q CITY,STATE,ZIP Lew V feTx 7 CERT. TESTER NO. 1 (, DATE DOUBLE CHECK VAL VE INSPECTION MUST BE CALLED FOR INSPECTION AT (817)481-0366 O:\FORM\BACKFLOW 9/12/96 P rya CITY OF GRAPEVINE 0 BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE 0 REPORT NAME OF PWS: GRAPEVINE PWS I.D.# CC}} Lj t2200013 LOCATION OF SERVICE- 130:5 PLUMBING PERMIT# _ 9 7 1 QC)1-5 THE BACKFLOW PREVENTION ASSEMBLY DETAILED BELOW HAS BEEN TESTED AND MAINTAINED AS REQUIRED BY TNRCC REGULATIONS AND IS CERTIFIED TO BE OPERATING WITHIN ACCEPTABLE PARAMETERS. TYPE OF ASSEMBLY REDUCED PRESSURE PRINCIPLE _PRESSURE VACUUM BREAKER J DOUBLE CHECK —ATMOSPHERE VACUUM BREAKER MANUFACTURER [) M F SIZE � L4 0 ��``�� MODEL �t S CC)) LOCATION OF METER RUY k o SERIAL NUMBER Reduced Pressure Principle Assembly Pressure Vacuum Breaker Double Check Valve Assembly Air Inlet Check Valve 1 at Check 2nd Check Relief Valve Open at_psid _paid Initial DC-Closed Tight_ Closed Tight_ Opened at_ Did not open_ Leaked Test RP-_psid/ // psid Leaked a/ Leaked V 44Zw IAc " vtiecb�,- / 1. Teel DC-Closed Tight_ Closed Tight�1 Opened et Opened at_psid _psid :,r.« ae :r RP—psid psid The above is certified to be true. FIRM NAME E I-�, Bwka C1�YV,C'E'y�y�� TESTER'S SIGNATURE RINT NAME S n 1 e) ADDRESS 1- c� " 3( y CITY,STATE,ZIP Leoj,,-,yj CERT. TESTER NO. �I �, 9(-6c(9,04 DATE 4 `I DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FOR INSPECTION AT (817)481-0366 O:\FORM\BACKFLOW 9/12/96 �l CITY OF GRAPEVINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: GRAPEVINE PWS I.D.# 2200013 LOCATION OF SERVICE /mod,-� PLUMBING PERMIT# �--� t�t THE BACKFLOW PREVENTION ASSEMBLY DETAILED BELOW HAS BEEN TESTED AND MAINTAINED AS REQUIRED BY TNRCC REGULATIONS AND IS CERTIFIED TO BE OPERATING WITHIN ACCEPTABLE PARAMETERS. TYPE OF ASSEMBLY REDUCED PRESSURE 'PRINCIPLE _ PRESSURE VACUUM BREAKER / DOUBLE CHECK _ ATMOSPHERE VACUUM BREAKER MANUFACTURER SIZE Vag! MODEL _ C1O7 LOCATION OF METER F-A SERIAL NUMBER 39370 J Reduced Pressure Principle Assembly Pressure Vacuum Breaker Double Check Valve Assembly Air Inlet Check Valve 1st Check 2nd Check Relief Valve Open at_psid _psid Initial DC-Closed Tight— Closed Tight_ Opened at_ Did not open_ Leaked Test RP-_psid psid Leaked Leaked �e M DC-Closed Tight_ Closed Tight__ Opened at_ Opened at_nsid _psid R� ar RP_psid psid The above is certified to be true. FIRM NAME i Cr 'I e C iC ( TESTER'S SIGNATURE PRINT NAME f � ADDRESS ��,C1, ff C}X .�j(�� ) CITY,STATE,ZIP LP i ° ; `)V I I IF ITS CERT. TESTER NO. 45 �( DATE A -52 7 -q E DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FOR INSPECTION AT (817)481-0366 O:\FORM\BACKFLOW 9/12/96 (!,6 q - r � CITY OF GRAPEVINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: GRAPEVINE PWS I.D.# QQ nn'' 2200013 LOCATION OF SERVICE c�V I t I l - C Son y PLUMBING PERMIT tf THE BACKFLOW PREVENTION ASSEMBLY DETAILED BELOW HAS BEEN TESTED AND MAINTAINED AS REQUIRED BY TNRCC REGULATIONS AND IS CERTIFIED TO BE OPERATING WITHIN ACCEPTABLE PARAMETERS. TYPE OF ASSEMBLY REDUCED PRESSURE PRINCIPLE _ PRESSURE VACUUM BREAKER DOUBLE CHECK _ ATMOSPHERE VACUUM BREAKER MANUFACTURER _ W A �] r/ SIZE MODEL 00-7 LOCATION OF METER SERIAL NUMBER-5 1(3 I Reduced Pressure Principle Assembly Pressure Vacuum BregLeaked Double Check Valve Assembly Air Inlet 1 st Check 2nd Check ERefiefValve Open at_psid Initial DC-Closed Tight-� Closed Tight_ Opened at_ Did not open_ Test RP-_psid / psid Leaked Leaked v! w: Cie�lnr L yisc. Ttw a DC-Closed Tight_ Closed Tight Opened et Opened at_psid _psid R< a, RP_psid psid The above is certified to be true. FIRM NAME B ibI -) 1 - co sefviLc i c TESTER'S SIGNATURE� > PRINT NAME S4eNA� , E I l ADDRESS CITY,STATE,ZIP CERT. TESTER NO. DATE q DOUBLE CHECK VALVE INSPECTION MUST BE CALLED FOR INSPECTION AT (817)481-0366 O:%FORM\BACKFLOW 9/12/96