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NO PERMIT NUMBER
CERTIFICATION OF RE-CLAIMED WATER SYSTEMS _�A •x. _ CROSS CONNECTION SPECIALISTS � �, BACKFLOW PREVENTION VALVE EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS ���' INSTALLATION-REPAIRS-TESTING-CERTIFICATION �x sher.(uu�9se 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 19500 Pruneridge Ave.,Cupertino/X-Wolfe MAILING ADDRESS The Hamptons CONTACT Edgarl Nov 0 .9 2005 I, 19500 Pruneridge Ave. TEL# 408-873-88T00Y1s__ Cupertino,CA 95014 MANUFACTURER MODELNUMBER TYPE SIZE SERIAL NUMBER Wilkins 975XL RP- 1 1/2" 532158 INTERNAL ❑ TAG LOCATION OF DEVICE prop line 40' from curb carport 21 irrigation EXTERNAL ® in enclosure IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX PAS FAIL❑ • REDUCED PRESSURE DEVICES PRESSURE TYPE,I ' ECHECPP VES - 'Fj:.l .... ., �.. BREAKERS --. ._ DOUBLE CHECK VALVES.... _- VACUUM BRE DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE/RELIEF NOA NO.2 VALVE AIR INLET CHECK VALVE CLOSED TIGHTCLOSED TIGHT 4 OPENED AT 12 LBS. OPENED AT_LBS CLOSED TIGHT ❑ INITIAL f Ibi7� p 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 ❑ OPENEDAT_LBS OPENED AT_LBS CLOSED TIGHT❑ TEST #LBS #LBS #LBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE CERTIFI INITIAL TEST BYZzd&l//WED TESTER N0. 10866 DATE,_11`04-05 ,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 CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS BACKFLOW PREVENTION VALVE EXPERT 1- INSTALLATION-REPAIRS-TESTING-CERTIFICATION �ID BACKFLOW PREVENTION SPECIAL�ISrTS1. . LICENSED CONTRACTOR C.C.L.#427328 CALIFORNIA (800)464-FLOW(3569)- --- 3750.E CHARTER PARK DR.,SAN JOSE CA 95136-1356 (408)269-260 -- 3608 FERNWOOD ST.,SAN MATEO CA 94403 FAX(408)269-2650 SERVICE ADDRESS 19500 Pruneridge Ave.,Cupertino/X-Wolfe MAILING ADDRESS The Hamptons CONTACT Edgar 19500 Pruneridge Ave. TEL# 873-8800 Cupertino,CA 95014 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Wilkins 975 RP 1 1/2° 595894 INTERNAL ❑ TAG LOCATION OF DEVICE next to carport 146 irrigation in enclosure EXTERNAL IF DEVICE IS A NEW INSTALLATION PLEASE CHECK THIS BOX[] PAS$ft FAIL❑ REDUCED PRESSURE DEVICES PRESSURE TYPE DOUBLE CHECK VALVES VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE/RELIEF N0.1 N0.2 VALVE AIR INLET CHECK VALVE CLOSDTIGHT CLOSED TIGHT Ig OPENED AT LBS. OPENED AT_LOS CLOSED TIGHT ❑ INITIAL lbs. 0 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❑ OPENED AT_LBS OPENED AT_LBS TEST *LBS YLBS sUBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY / " 'A` ) w"l�r CERTIFIED TESTER NO. 10866 DATE 11-04-05 MO. DAY YR. 0, 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 , y INSTALLATION-REPAIRS-TESTING-CERTIFICATION • ^Sfat�(��9�• BACKFLOW PREVENTION SPECIALISTS, INC. -- LICENSED CONTRACTOR C.C.L.#427328 CALIFORNIA (800)464 FLOW Z35-6 ) 3750-E �%� 3750-E CHARTER PARK DR.,SAN JOSE CA 95136-1356 (408)269-2600 v,°�`- I 3608 FERNWOOD ST.,SAN MATEO CA 94403 FAX(408)269-2650 NIn V 2005 SERVICE ADDRESS 19500 Pruneridge Ave.,Cupertino/X-Wolfe MAILING ADDRESS The Hamptons CONTACT Edgar 19500 Pruneridge Ave. TEL# 873-8800 Cupertino,CA 95014 MANUFACTURER MODELNUMBER TYPE SIZE SERIAL NUMBER Wilkins 975 RP 11/2" 595500 INTERNAL ❑ TAG LOCATION OF DEVICE left of basketball court irrigation in enclosure EXTERNAL IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX[j PAS FAIL❑ • REDUCED PRESSURE DEVICES PRESSURE TYPE DOUBLE CHECK VALVES VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE I RELIEF NOA �A NO.2 VALVE AIR INLET CHECK VALVE CLOSED TIGHT CLOSED TIGHT OPENED AT - ._LBS. OPENED AT_LBS CLOSED TIGHT ❑ INITIAL #IN. Q 6/ #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 #LBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE/ INITIAL TEST BY V , �I�'�^ CERTIFIED TESTER NO. 10866 DATE 11-04-05 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 IFIED CROSS CONNECTION CONTROL CONSULTANTS BACKFLOW PREVENTION VALVE EXPERT CERT ) ., 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 7--�� Trq7-� 1�-� 3608 FERNWOOD ST.,SAN MATEO CA 94403 FAX(408)269-2650 JC` ECFil !/ Xil� SERVICE ADDRESS 19500 Pruneridge Ave.,Cu ertino/X-Wolfe NOV © N 2885 MAILING ADDRESS The Hamptons CONTACT Edgar BY:--- .- __ 1 19500 Y:---- - 19500 Pruneridge Ave. TEL# 873-8800 Cupertino,CA 95014 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Wilkins 975XL RP 11/2° 652499 INTERNAL ❑ TAG LOCATION OF DEVICE right of carpor 111 irrigation in enclosure EXTERNAL IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX[3 PASS FAIL❑ REDUCED PRESSURE DEVICES VVV �- PRESSURE TYPE DOUBLE CHECK VALVES VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE/RELIEF N0.1 N0.2 VALVE AIR INLET CHECK VALVE CLOSED TIGHT CLOSED TIGHT OPENED AT-I1 LBS. OPENEDAT_LBS CLOSEDTIGHT ❑ INITIAL •Ibs. `0 . sR' 0lbs. #LBS 9 LBS. TEST —'•TT 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 OPENED AT_LBS OPENED AT_LBS � ALBS OLBS *LBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY CERTIFIED TESTER NO. 10866 DATE 11-04-05 MO. DAY YR. REPAIRED BY DATE 1 FINAL TEST BY CERTIFIED TESTER NO. DATE MO. DAY YR.