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HomeMy WebLinkAboutPermit Backflow Test 2008-2-7 . ~~. :: _.,~~ tr~ ',,' \". "'~:" '_ ,'? ~;~ '*" ' ''': -- '~. .:.. .f. . ., -'.~1. .8 ~ -,:, PNWS:AWWA, ,,- ".;'" . '. *.....~.. . ~;;'"'':-~ -f}"~~--- ..... .?~ ~', ,=:>-;;~:~~~. .- -~. ...:. --,-'- ",:;'.- -- .~ -' ': --..... .. ,- '" 7~?'~r5'''~ 'S::,;?->":,: -';".. ;... '.' ......1~,.'>., '"' PROPERTY OWNER;: , -',~....,M~ILING :;, "~."~' ADDRESS: . " : -'.' ,; ~'f;~\,,,' ',' ~CITY. .,1'/;Jj?;~~:/"~::~~':~~'l!;':tE 't1~,~' ZIP t(Ji/~78 :~: : ~i~:~~; >72 ?"8 ':, 85:f' ;r;;,~:~tJ - ' ",," , ~ ' ': ., { "", ' " " ,C ' '.... STR~F~ ' , ,~ ' '<', " <". 'c ,:~ , """., :rx,g.~:~:~,:A:,O 'D.C.v.A.<l~ R.P.D.A. q D.C:D.A.'J~tv.B.A.;o.Ds,v.B.A: DA.V.~..' q~R'GAP" ,r ;;,;'s;ii1::B)i:i.".lI~'~' MAK'E: ~ I! i< /" hf .. MODEL:',2. 2.0/0:>1' .. ~;;t;'SV~i~'Ri',;~," " ',~ " ;';I '., '. ,,' " SERIAL '-/'""'/" ./~7;' ,..'tfi,[~:/~;-X' ,"'."I'URvtVOR:'" ,;" ,..I UK "" " "NUMBER:'-T,' 7',' ()::>7.i~.:.. ~:~~J~~~~ftvg~':\~:~:ICJ~;;A.';"".~5 /d~ ,: n~?lje'., ~'.' :_<:'::,~~'f~;~~~:.-'/':~':->::"" . ".c" . ,>... .... :,~~:',' ~. . . ~, '--, . ..',.... ~~I'NE~""'<' ,. .'". ..': ,'.~~', . . ' , " ' tJ'EXISTING. : ,," BAc-iQ'LeW"ASSEMBLYTESTnpO~T 'DRE:M,O~~ED:,' :':_: '. -",':''lI!7.'' "~'-.;;"': -';":'. ....: . . .,.~:;.OREP.L~~EM.EN:!:Y , :-:;.;,,If '6/a;Yhf:'l!,.(!!i!..r 'PHON,E,: ' , ~ . - ~ " .".. 'A";.. " REDUCED PRESSURE ASSEMBLY . P.V.BA I. s,v:S,^, ,r; ~lNi:riAI.."tEsT,<." ~. . ~ \. :~~~i~~~; : .," '(A)LI'!.~.~::~~~~,~i ~,~ET... ':' '~~t:.~>; ~~~f~l...:~.!t~.,...'.~.i~r~".:, ",,> ';;~I . '" .'. _~... - _ _ ~ ','" _ ~ ,-'-""f.'!:.....tf!"':,;~:I...,-..,~__~ JNITIALRELlEFVf.I,:VE,'., '(B)ITIGHT 0" i OPENED AT: PRESS'DROP ,,,4,:"';"''::'./.i:::A P:.;,TES'f" OP~N.ED'AT ',' .' , ,. ' .::;,. '~, ;. ..,' , , " . 'P'ATEf;"'i~~" '';'';'''''',:': ~.' .- ':~' . MIN2 ~Slpj, ,LE;AKEDm~,~t"~':::;"'f.'ffl)'f7tD~::'i~~'I?-'~'/"'" ' ....' '!t:'''~ RE~YJ..TS BUFFER' ,~" {,k' ,~~;''''i,,,_,,,, ;::r.L L- /', .. . ,.f'. A-.B= ' ,r", I ,CHECKt#:r!{)Ii,.\,;:.'P~ID., PSIQ, , r".'_ '\ MIN 3 p~f~' . _ _ i::.....~t'" . _' ~ ':iit ~ ,_ '. - i" ~ RELIEI:VALVE. ITIGHT,~:~.,JO..i"...,.,./J:':.~.o,'" :g~:DF~D ~~ISTEM.'" PAS~O, ".!-;AIL 0 ILEAKED,' ';~1t '.; , ,}ID'-...'" , , '.L)~~C>(fW+' d~dtU'~d.,t41e* Vc,./~C3' COMMENTS fJ' . , , '" :i'- ..". -' , '. : ' ~~A}~d/s ~~ . ,'.' '. ' '., "- , PARTS " '\ -"- ,<,,' " \ J , . iii CHE~iDUCEDPRESSURE'ASS/EM,BLY DCiV'A.....".}...\ P.V;B.A.fS,V.~.A:, AFTER 'R~PAlRS '~RESS DROP " (A) ...... ., . DATE: ' ," ;5~:'-::';~~~~.~:~~B) : ;~~~: ~'" ps~': :'~::~T p~1!gP . 2./ 7./ ? ~:~;-.~,'::;': -",'., ;':"';~~ \ TIGHT 0 PS10,";.. PSID' " pSIDP~SSED frzJ\. ..c'!- ';, :':'.':"'''''~~~.;'!J;/lCO~pLETlNG AND SUBMrrnNG .TIlIS TESTRlipORT; TIlETESTEi;, CERTIFIES llIAT lliE ,', , '.i '/:">':"~c ASSEMBLY. HAS' BEEN TEs:rEDAND'MAINTAlNEDIN ACCORDANCE ,wrffi ALL APPLICABLE " ", RULES.. AND REGULATIONS OF llIE WATER. SYSTEM AND 'STATE REGULATIONS' , :G~!~!;J;!;)1:;fJO~ADING TESTER SIGNAi'ORE '. William:W Kinglfey II / ,- _ 'TES1USNAMJ; pRIt':fED 'PO Box.71~O;,! l::ug. UI'\ ~(,~J,! .~ TESTERS ADDRESS, _ :;\' l":l;;.;~le'A' Speri<llI!iA~' -.. :;:.:. ....=-~._- ~ ->.....:. " TEST~ _ " AFfER 'REPAIRS COMPANY NAME. ( .104"q:ERTN 'c _ 'O3O&1-~~.. .., ','., .,' ,729-551~~GE" J ;- :~Ht:~, ~,>?k ':~ ' . . _ _ ", .~:,'r.' _'-' . ' Cl ~E~V.IC~ ,~ESJO~I? . ..~~.,~~fJtJ;l~;+.' \' .-', .::'. '. ~'REPORT RECEIVED BY '.-,~ (REpRE,SEI'ITAjiVE OF OWNER) .) ,L w~~~ ~:~ syS~:t~~~~~~..;',;;:::'~"p;'N,.. './ CllSl~;CoPY .' ~( ;-oft,1',: ~ . -