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NO PERMIT NUMBER - BF2 "��/�w� CROSS CONNECTION SPECIALISTS CERTIFICATION OF RE-CLAIMED WATER SYSTEMS , 4Y""• "` , Fey- 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 95736-1356 (408)269-2600 1522-A DAY AVE.,SAN MATEO CA 94403 FAX(408)269.2650 SERVICE ADDRESS 20215 Stevens Creek Blvd.,CUpertino/X-Vista Dr . . MAILING ADDRESS Santa Clara County Fire Dept. CONTACT Steve 0 C T 2 6 2004 14700 Winchester Blvd TEL# 378-401018 . Los Gatos,CA 95032 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Febco 825Y RP 2° A247246 INTERNAL ❑ TAG LOCATION OF DEVICE irrigation EXTERNAL IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX 13 PASS FAIL❑ REDUCED PRESSURE DEVICES PRESSURE TYPE • DOUBLE CHECK VALVES VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE I RELIEF NOA NO.2 VALVE AIR INLET CHECKVALVE CLOSED�yTI�iHT CLOSED TIGHT )� OPENED AT_(7 LBS. OPENED AT_LBS CLOSED TIGHT ❑ INITIAL Olbe. ' i5/ 61Da. SLBS OLBS. TEST OPENED UNDER 2.0 OPENED UNDER 1.0 LEAKED ❑ LEAKED ❑ OR DID NOT OPEN ❑ OR DID NOT OPEN Cl LEAKED Cl REPAIRS AND MATERIALS USED FINAL CLOSED TIGHT❑ CLOSED TIGHT Cl OPENED AT_LBS OPENED AT_LBS CLOSED TIGHT❑ '�.;, TEST OLBS *LBS 1LBS THE ABOVE REPORT IB CERTIFIED TO BE TRUE INITIAL TEST BY /, �6' �"� _ .-CERTIFIED TESTER NO. 10220 DATE 10-19-04 MO. DAY YR. • REPAIRED BY DATE Y FINAL TEST BY CERTIFIED TESTER NO. DATE r MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS gA�K�� CROSS CONNECTION SPECIALISTS CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS BACKFLOW PREVENTION VALVE EXPERT INSTALLATION-REPAIRS-TESTING-CERTIFICATION SBACKFLOW PREVENTION SPECIALISTS, INC. LICENSED CONTRACTOR C.C.L.#427328 CALIFORNIA (800)464-FLOW(3589 T� 3750-E CHARTER PARK DR.,SAN JOSE CA 95136.1358 (408)269.2600 1 `;_�:;r•T�T D 1522-A DAY AVE.,SAN MATEO CA 94403 FAX(408)289-2650' UL SERVICE ADDRESS 20215 Stevens Creek Blvd.,Cu ertino/X-Vista Dr Cal Water LosAltos MAILING ADDRESS Santa Clara County Fire Dept. CONTACT SteveY 14700 Winchester Blvd TEL# 3784010 Los Gatos,CA 95032 MANUFACTURER MODEL NUMBER TYPE SIZE _ SERIAL NUMBER Febco 825Y RP 2° 205258 INTERNAL ❑ TAG LOCATION OF DEVICE on Vista Dr main water mtr#32601822 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 CHECKVALVE PRESSURE I RELIEF NOA NO.2 VALVE AIR INLET CHECKVALVE CLOS�FID T GHT CLOSED TIGHT OPENED AT - LBS. OPENED AT_LBS CLOSED TIGHT ❑ INITIAL 0IEa. l L CWs. #LBS #LBS. TEST OPENED UNDER 2.0 OPENED UNDER 1.0 LEAKED ❑ LEAKED ❑ OR DID NOT OPEN ❑ OR DID NOT OPEN Cl LEAKED ❑ REPAIRS AND MATERIALS USED FINAL CLOSED TIGHT El CLOSED TIGHT ❑ OPENED AT_LBS OPENED AT_LBS CLOSED TIGHT❑ TEST #LBS #LBS #LBS THE ABOVE REPORT 18 CERTIFIED TO BE TRUE INITIAL TEST BY � 14 CERTIFIED TESTER NO. 10220 DATE 10-19-04 MO. DAY YR. REPAIRED BY DATE • FINAL TEST BY CERTIFIED TESTER NO. DATE MO. DAY YR.