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BACKFLOW PREVENTION SPECIALISTS e� CROSS CONNECTION SPECIALISTS CERTIFICATICN OF RE-CLAIMED WATER SYSTEMS :f"`4 BACKFLOW PREVENTION VALVE EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTSu� INSTALLATION-REPAIRS-TESTING-CERTIFICATION BACKFLOW PREVENTION SPECIALISTS, INC. LICENSED CONTRACTOR C.C.L.#427328 CALIFORNIA (800)464-FLOW(3589) 3750-E CHARTER PARK DR.,SAN JOSE CA 95136-1356 (408)269-2600 3608 FERNWOOD ST.,SAN MATEO CA 94403 FAX(408)269-2650 FCFTVED SERVICE ADDRESS 19111 Pnrueridge Ave.,Cupertino MAK I 2003 MAILING ADDRESS Siemens Bldg Tech. Run:Jamie Spadaro CONTACT Todd Y 801 Ashbury Dr. TE L# 4474710 Buffalo Grove,IL 60089 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Hersey FRPH RP '�2„ -51344- INTERNAL TAG LOCATION OF DEVICE Bldg 46T �d S� !-?44M�A EXTERNAL U IF DEVICE IS A NEW INSTALLATION PLEASE CHECK THIS BOX❑ PASSfp. FAIL❑ •/ REDUCED PRESSURE DEVICES . . . . . _.. _. PRESSURE TYPE I: DOUBLE CHECK VALVES ,. VACUUM BREAKERS', , I-. RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE/RELIEF N0.1 N0.2 VALVE AIR INLET CHECK VALVE CLOSEDTIGHTB CLOSED TIGHT OPENED AT C�2' LBS. OPENED AT_LBS CLOSED TIGHT ❑ INITIAL #Ibs. #Iba. #LBS #LES. TEST OPENED UNDER 2.0 OPENED UNDER 1.0 LEAKED ❑ LEAKED ❑ OR DID NOT OPEN ❑ OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS AND MATERIALS - — -USED FINAL CLOSED TIGHT❑ CLOSED TIGHT ❑ OPENED AT_LBS OPENED AT_LBS CLOSED TIGHT❑ TEST #LBS #LBS #LBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIALTESTB - -J---- -CERTIFIED.TESTER NO.48 DATE-1-23-03 t . 'MO REPAIRED BY �,;,, DATE �.._ .,. .. .. . . _ .. FINAL TEST BY CERTIFIED TESTER NO. DATE MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS 4 '//�. CROSS CONNECTION SPECIALISTS CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS BACKFLOW PREVENTION VALVE EXPERT INSTALLATION-REPAIRS-TESTING-CERTIFICATION 0 BACKFLOW PREVENTION SPECIALISTS, INC, LICENSED CONTRACTOR C.C.L.#427328 CALIFORNIA (800)464-FLOW(3569) 3750-E CHARTER PARK DR.,SAN JOSE CA 951361356 (408)269-2600 1522-A DAY AVE.,SAN MATEO CA 94403 FAX(408)269-2650 SERVICE ADDRESS 19111 Pnmeridge Ave. Cupertino MAILING ADDRESS Siernens Technologies attn: Jamie Spadaro CONTACT TGdd ' 801 Asbury DrTEL# 447-2596 Buffalo Grove,IL 60089 MANUFACTURER MODEL NUMBER TYPE zSIZE SERIAL NUMBER Febco 825Y RP � ' 11 A176579 ,/,/` INTERNAL TAG LOCATION OF DEVICE (1/-Q(..� `kBd NIM EXTERNAL; ���•��I��, IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX❑ PAS! FAIL❑ REDUCED PRESSURE DEVICES PRESSURE TYPE DOUBLE CHECK VALVES VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECKVALVE CHECK VALVE PRESSURE/RELIEF N0.1 N0.2 VALVE AIR INLET CHECK VALVE CLOSEDTjGHTQ CLOSED TIGHT OPENEDAT_LBS. OPENEDAT_LBS CLOSEDTIGHT ElINITIAL #lbs. 71� _ #lbs. #LBS #LBS. TEST OPENED UNDER 2.0 OPENED UNDER 1.0 LEAKED ❑ LEAKED ❑ OR DID NOT OPEN ❑ OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS AND MATERIALS ' USED FINAL CLOSED TIGHT❑ CLOSED TIGHT ❑ CLOSED TIGHT❑ TEST #LBS #LBS OPENED AT_LBS OPENED AT_LBS tLBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST Y �'��CERTIFIED TESTER N0.48 DATE 1-23-02 MO. DAY YR. REPAIRED BY DATE FINAL TEST BY CERTIFIED TESTER NO. DATE MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS CROSS CONNECTION SPECIALISTS BACKFLOW PREVENTION VALVE EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS _C, INSTALLATION-REPAIRS-TESTING-CERTIFICATION i • Spior.Ctw�9we BACKFLOW PREVENTION SPECIALISTS, INC. LICENSED CONTRACTOR C.C.L.#427328 CALIFORNIA (800)464-FLOW(3569) 3750-E CHARTER PARK DR.,SAN JOSE CA 95138-1356 (40B)269-2600 3608 FERNWOOD ST.,SAN MATEO CA 94403 FAX(408)269-2650 SERVICE ADDRESS 19111 Pcuneridge Ave. Cupertino MAILING ADDRESS Siemens Bldg Tech, attn:Jame Spadaro CONTACT Todd 801 Ashbuty Dr. TEL# 447-4710 Buffalo Grove,IL 60089 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Hersey 6CM 4" 89708 INTERNAL Cl TAG LOCATION OF DEVICE on Homestead east of Wolfe at gate 4 EXTERNAL fz! t" IF DEVICE IS A NEW INSTALLATION PLEASE CHECK THIS BOX❑ PASS FAIL❑ • REDUCED PRESSURE DEVICES PRESSURE TYPE DOUBLE CHECK VALVES VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECKVALVE CHECK VALVE PRESSURE/RELIEF NO.1 NO.2 VALVE AIR INLET CHECK VALVE CLOSLp T�IG/H CLOSED TIGHT OPENEDAT� LBS. OPENEDAT_LBS CLOSEDTIGHT ❑ INITIAL Ch.T #Iba. #LBS A LBS. TEST OPENED UNDER 2.0 OPENED UNDER 1.0 LEAKED ❑ LEAKED ❑ OR DID NOT OPEN Cl OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS AND MATERIALS USED FINAL CLOSED TIGHT❑ CLOSED TIGHT ❑ CLOSED TIGHT❑ OPENED AT_LBS OPENED AT_LBS TEST pLgg pLgg tLBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST B CERTIFIED TESTER NO.48 DATE 1-23-03 MO. DAY YR. REPAIRED BY DATE FINAL TEST BY CERTIFIED TESTER NO. DATE T M0. DAY YR. u, i _.6/Lam•Rai�ya„ CROSS CONNECTION SPECIALISTS CERTIFICATION OF RE-CLAIMED WATER SYSTEMS 45'"'-" � .;.'+e BACKFLOW PREVENTION VALVE EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS• ,_,,' - INSTALLATION-REPAIRS-TESTING-CERTIFICATION BACKFLOW PREVENTION SPECIALISTS, INC. LICENSED CONTRACTOR C.C.L.#427328 CALIFORNIA (800)464-FLOW(3569) 3750-E CHARTER PARK DR.,SAN JOSE CA 95136.1356 (408)269-2600 3608 FERNWOOD ST.,SAN MATEO CA 94403 FAX(408)269-2650 SERVICE ADDRESS 19111 Proneridge Ave.,Cupertino _ MAILING ADDRESS Siemens Bldg Tech, Ban:Jamie Spadaro CONTACT Todd 801 Ashbury Dr. TEL# 447-4710 Buffalo Grove, IL 60089 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Hersey FRPII RP 2" 146520 INTERNAL TAG LOCATION OF DEVICE neargate#1 irrigation EXTERNAL ,FKV IF DEVICEJS ANEW INSTALLATION PLEASE CHECK THIS BOX PASS FAIL❑ • REDUCED PRESSURE DEVICES PRESSURE TYPE DOUBLE CHECK VALVES VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE/RELIEF NOA NO.2 VALVE AIR INLET CHECK VALVE CLOS TIGHT CLOSED TIGHT—� OPENED ATZ LBS. OPENEDAT_LBS CLOSED TIGHT ❑ Y� INITIAL #tbs. °� 9tbs. #LBS ALBS. TEST OPENED UNDER 2.0 OPENED UNDER 1.0 LEAKED ❑ LEAKED ❑ OR DID NOT OPEN Cl OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS AND MATERIALS USED FINAL CLOSED TIGHT❑ CLOSED TIGHT ❑ CLOSED TIGHT❑ OPENED AT—LBS OPENED AT_LBS TEST III LBS #LB3 tLBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST B CERTIFIED TESTER NO,48 DATE 1-23-03 • REPAIRED BY DATE MO. DAY YR. FINAL TEST BY CERTIFIED TESTER NO. DATE MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS CROSS OW PR CTION SPECIALISTS BACKFLOW PR CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS, }.�'_,' EVENTION VALVE EXPERT INSTALLATION-REPAIRS-TESTING-CERTIFICATION BACKFLOW PREVENTION SPECIALISTS, INC. LICENSED CONTRACTOR C.C.L.#427328 CALIFORNIA (800)484-FLOW(3569) 3750-E CHARTER PARK DR.,SAN JOSE CA 95136-1356 (408)269-2600 3608 FERNWOOD ST.,SAN MATEO CA 94403 FAX(408)269-2650 SERVICE ADDRESS 19111 Pmneridge Ave.,111 AveCupertino MAILING ADDRESS Siemens Bldg Tech. Sun:Jamie Spadaro CONTACT Todd 801 Ashbury Dr. TEL# 447-4710 Buffalo Grove,IL 60089 MANUFACTURER MODEL NUMBER TYYP SIZE SERIAL NUMBER { Febco 860 ' `v 4" 10181301 INTERNAL ❑ TAG _ LOCATION OF DEVICE 3rd driveway on Homestead east of Wolfe at gate 6 EXTERNAL IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX PASS❑ FAILt • REDUCED PRESSURE DEVICES PRESSURE TYPE DOUBLE CHECK VALVES VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE I RELIEF - NO.1 NO.2 VALVE,, AIR INLET CHECK VALVE CLOSED TIGHT Q CLOSED TIGHT ❑ OPENEDAT LBS. OPENEDAT_LBS CLOSEDTIGHT ❑ INITIAL #Lbs. —!;. Z Clbs. #LBS #LBS. TEST r OPENED UNDER 2.0 OPENED UNDER 1.0 LEAKEDI LSI LEAKED ❑ OR DID NOT OPEN Cl OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS AND MATERIALS USED FINAL CLOSED TIGHT❑ CLOSED TIGHT ❑ CLOSED TIGHT OPENED AT_LBS OPENED AT_LBS ❑ TEST #LBS #LBS 8LBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIALTEST EY _ CERTIFIED TESTER N0.48 DATE 1-23-03 M0. DAY YR. • REPAIRED BY DATE FINAL TEST BY CERTIFIED TESTER NO. DATE MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS _ •� �-- � CROSS CONNECTION SPECIALISTS �CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS �'�"" BACKFLOW PREVENTION VALVE EXPERT� �� INSTALLATION-REPAIRS-TESTING-CERTIFICATION BACKFLOW PREVENTION SPECIALISTS, INC. LICENSED CONTRACTOR C.C.L.#427328 CALIFORNIA (800)464-FLOW(3589) 3750-E CHARTER PARK DR.,SAN JOSE CA 95136-1356 (408)269-2600 3608 FERNWOOD ST.,SAN MATEO CA 94403 FAX(408)269-2650 SERVICE ADDRESS 19111 Pruncridge Ave.,Cupertino MAILING ADDRESS Siemens Bldg Tech. attn: Jamie Spadaro CONTACT TOM 801 Ashbury Dr. TEL# 447-4710 Buffalo Grove,IL 60089 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Febco 860 $1� 4, 11061317 INTERNAL ❑ TAG LOCATION OF DEVICE on Homestead east Of Wolfe at gate 6 EXTERNAL IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX❑ PASS FAIL❑ • REDUCED PRESSURE DEVICES PRESSURE TYPE DOUBLE CHECK VALVES VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE I RELIEF NO.1 NO.2 VALVE AIR INLET CHECK VALVE CLOSEq TIGHT CLOSED TIGHT OPENEDAT_LBS. OPENEDAT_LBS CLOSEDTIGHT ❑ INITIAL #115 1111* #LBS #LBS. TEST OPENED UNDER 2.0 OPENED UNDER 1.0 LEAKED ❑ LEAKED ❑ OR DID NOT OPEN ❑ OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS AND MATERIALS USED FINAL CLOSED TIGHT❑ CLOSED TIGHT ❑ CLOSED TIGHT❑ OPENED AT_LBS OPENED AT_LBS TEST pLBS pLBS tLBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY CERTIFIED TESTER NO.48 DATE 1-23-03 '1 MO. DAY YR. - • REPAIRED BY DATE FINAL TEST BY CERTIFIED TESTER NO. DATE MO. DAY YR. CROSS CONNECTION SPECIALISTS CERTIFICATION OF RE-CLAIMED WATER SYSTEMS -, � A BACKFLOW PREVENTION VALVE EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS INSTALLATION-REPAIRS-TESTING-CERTIFICATION 1 %ACKFLOW PREVENTION SPECIALISTS, INC. LICENSED CONTRACTOR C.C.L.#427328 CALIFORNIA (800)464-FLOW(3569) 3750-E CHARTER PARK DR.,SAN JOSE CA 95136.1356 (408)269-2600 � 3608 FERNWOOD ST.,SAN MATEO CA 94403 FAX(408)269-2650 1 T SERVICE ADDRESS 19111 Pruneridge Ave.,Cupertino .IAN MAILING ADDRESS Emcor CONTACT Henry BY•--". 10 N. CalvertSt., Ste. 200 MS 100 TEL# 773-6220 Baltimore, MD 21202 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Febco 860-__— ___ RP 4 _^._0010181301— - INTERNAL ❑ TAG LOCATION OF DEVICE 3rd driveway on Homestead east of Wolfe at gate 6 EXTERNAL ® Bldg 44 IF DEVICE IS A NEW INSTALLATION PLEASE CHECK THIS BOX[3 .PASS FAIL-0.._ • REDUCED PRESSURE DEVICES PRESSURE TYPE DOUBLE CHECK VALVES -VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE I RELIEF N0.1 N0.2 VALVE AIR INLET CHECKVALVE CLOSED TIGHT ❑ CLOSED TIGHT ❑ OPENED AT_LBS. OPENED AT_LBS CLOSED TIGHT ❑ INITIAL #lbs. #lbs. #LBS #LBS. TEST �r OPENED UNDER 2.0 OPENED UNDER 1.0 • 1 LEAKED Ll� LEAKED ❑ OR DID NOT OPEN ❑ OR DID NOT OPEN Cl LEAKED ❑ REPAIRS Cteat t AND 5er\; MATERIALS '# I ' USED ,/ ^ FINAL CLOSED TIGHT LH CLOSED TIGHT 19 CLOSED TIGHT Cl TEST #LBS� #LBS OPENED AT_LBS OPENED AT_LBS #LBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY / .1 -. - CERTIFIED TESTER N0• I0466 DATE. 12-28-05 'MO. DAY YR. • REPAIRED By' ' a.$-c�5 '-• ' . lll...f GATE FINAL TEST BY CERTIFIED TESTER NO. /�SI(p(' DATE /p0 -as-QS MO. DAY YR.