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BACKFLOW CERTIFICATION OF RE-CLAIMED WATER SYSTEMS ,baa' CROSS CONNECTION SPECIALISTS CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS 'I' 'E' BACKFLOW PREVENTION VALVE EXPERT INSTALLATION-REPAIRS-TESTING-CERTIFICATION CALIFORNIA (800)464-FLOW(3569) • LOCAL(408)269-2600Spm LICENSED CONTRACTOR C.C.L.#427328 FAX(408)269-2650 3750-E CHARTER PARK DR.,SAN JOSE CA 95136-1356 BACKFLOW PREVENTION SPECIALISTS, INC. MAILING/OWNER James J Viso Engineering Inc. SERVICE Whole Foods Market Address ADDRESS PO Box 150 20955 Stevens Creek Blvd. Santa Clara,CA.95052 Cupertino,CA. 95014 CONTACT:Joe J Viso TEL# 408.296.2125 MANUFACTURER MODEL NUMBER TYPE 1SIZE#14 - ' —87spil UMBER WILKINS 375 RP 3JUN ® '/ 2007 L3I340 NEW INSTALLATION: REPLACEMENT: REPLACEMENT DEVICE INFORMATION MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER LOCATION OF DEVICE INTERNAL ❑ METER# EXTERNAL& TAG# Hazard Tyne: Irrigation • REDUCED PRESSURE DEVICES PRESSURE TYPE Shutoff Valves DOUBLE CHECK VALVES VACUUM BREAKERS DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE/RELIEF AIR INLET CHECK VALVE NO.1 NO.2 VALVE #1 # q 2 CLOSE T`GHT CLOSED TIGHT (9 OPENED AT�•Ot LBS. OPENED AT LBS CLOSED TIGHT❑ CLOSEDTIGHT❑91 INITIAL #Ibs. V .9Ibs. OPENED UNDER 1.0 #LBS. LEAKED ❑ ❑ TEST OPENED UNDER 2.0 R DID NOT OPEN❑ LEAKED ❑ LEAKED ❑ OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS AND MATERIALS USED FINAL CLOSED TIGHT ❑ CLOSED TIGHT ❑ CLOSED TIGHT❑ - TESTOPENED AT_#LBS OPENED AT_#LB CLOSEDTIGHTD ALBS #LBB ALBS ❑ Comments: ..4-0ti. Ips THE ABOVE REPORT IFI D TO BE TRUE F ' ,. PASS CERTIFIED TESTERNO. 10466 DATE 06/(71/07 FAIL �ITIAL TEST BY _ ❑ MO. DAY YR. REPAIRED BY DATE PASS ❑ FINAL TEST BY CERTIFIED TESTER NO. DATE FAIL ❑ MO. DAV YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS rb�°P" p'°0r4 CROSS CONNECTION SPECIALISTS CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS '2' 'i' BACKFLOW PREVENTION VALVE EXPERT INSTALLATION-REPAIRS-TESTING-CERTIFICATION CALIFORNIA (800)464-FLOW(3569) LOCAL(408)269-2600 Spy q,sa• LICENSED CONTRACTOR C.C.L.#427328 FAX(408)269-2650 3750-E CHARTER PARK DR.,SAN JOSE CA 95136-1356 "41BACKFLOW PREVENTION SPECIALISTS, INC. MAILING/OWNER George M Robinson &Co SERVICE Whole Foods Market Address ADDRESS 852 85th Ave 20955 Stevens Creek Blvd. Oakland,CA 94621 Cupertino,CA. 95014 CONTACT:Jeff Joyce TELP 408-691-3471 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Febco 805YB DC 3/4" H008292 NEW INSTALLATION:® REPLACEMENT: REPLACEMENT DEVICE INFORMATION MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER LOCATION OF DEVICE INTERNAL ❑ METER# 82501700 - - EXTERNAL® TAG# JUL U 2 2007 Hazard Tvoe:Fire Bypass r REDUCED PRESSURE DEVICES • PRESSURE TYPE Shutoff Valves DOUBLE CHECK VALVES VACUUM BREAKERS DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE/RELIEF AIR INLET CHECK VALVE NO.1 NO.2 VALVE ,y #1 #2 CLOSlf�D�IGHT ICI CLOSED TIGHT OPENED AT_LBS. OPENED AT—LBS CLOSED TIGHT❑ CLOSEDTIGHTipI INITIAL #Ibs. s #Ibs. A #LBS. LEAKED ❑ ❑ TEST OPENED UNDER 2.0 OPENEDUNDERI.O R DID NOT OPEN❑ LEAKED ❑ LEAKED ❑ OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS AND MATERIALS USED FINAL CLOSED TIGHT❑ CLOSED TIGHT ❑ CLOSED TIGHT❑ OPENED AT_#LBS PENED AT_pLB CLOSED TIGHT❑ D TEST pLBS ALBS pLBS Comments: THE ABOVE RE IS ERTIFI T BE TR PASS INITIAL TEST BV CERTIFIED TESTER NO, 10466 DATE 06/26/07 FAIL MO. DAY YR. GEPAIRED BY DATE PASS ❑ FINAL TEST BY CERTIFIED TESTER NO. DATE FAIL ❑ MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS ,6�G�^r' CROSS CONNECTION SPECIALISTS CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS '2' Z' BACKFLOW PREVENTION VALVE EXPERT INSTALLATION-REPAIRS-TESTING-CERTIFICATION CALIFORNIA (800)464-FLOW(3569) `. LOCAL(408)269-2600 Spm�qKe. LICENSED CONTRACTOR C.C.L.#427328 FAX(408)269-2650 3750-E CHARTER PARK DR.,SAN JOSE CA 95136-1356 GBACKFLOW PREVENTION SPECIALISTS, INC. MAILING/OWNER George M Robinson&Co SERVICE Whole Foods Market Address ADDRESS 852 85th Ave 20955 Stevens Creek Blvd. Oakland,CA 94621 Cupertino,CA. 95014 CONTACT:Jeff Joyce TEL# 408-691-3471 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Febco 856 DCDA 6" F0607111059 NEW INSTALLATION:gg REPLACEMENT: REPLACEMENT DEVICE INFORMATION MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER LOCATION OF DEVICE - A 'k 0 V INTERNAL ❑ METER# 82501700 JUL 0 2 2007 EXTERNAL® TAG# — Hazard Type:fire service REDUCED PRESSURE DEVICES PRESSURE TYPE • Shutoff Valves DOUBLE CHECK VALVES VACUUM BREAKERS DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE/RELIEF AIR INLET CHECK VALVE NO.1 NO.2VALVE r"t� � a1 a�zf CLOSED TIGHT CLOSED TIGHT OPENED AT_LBS. OPENED AT16 _LES CLOSED TIGHT❑ CLOSED TIGHT® 1 INITIAL q lbs. 3.q #lbs. U''1 OPENED UNDER 1.0 #LBS. LEAKED ❑ ❑ TEST OPENED UNDER 2.0 OR DID NOT OPEN❑ LEAKED ❑ LEAKED ❑ OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS AND MATERIALS USED FINAL CLOSED TIGHT ❑ CLOSED TIGHT ❑ OPENED ATCLOSED TIGHT _ILBS PENED AT_gLB CLOSED TIGHT❑ ❑ TEST gLBS ALBS aL85 Comments: THE ABOVE R IS C RTIFIE TA PASS INITIAL TEST BV / CERTIFIED TESTER NO. 10466 DATE 06/26/07 FAIL MO. DAY VR. EPAIRED BY DATE PASS ❑ FINAL TEST BY CERTIFIED TESTER NO. DATE FAIL ❑ MO. DAY VR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS t °0° CROSS CONNECTION SPECIALISTS CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS 'f' , '3' BACKFLOW PREVENTION VALVE EXPERT INSTALLATION-REPAIRS-TESTING-CERTIFICATION CALIFORNIA (800)464-FLOW(3569) �•��� LOCAL(408)269-2600 g LICENSED CONTRACTOR C.C.L.#427328 FAX(408)269-2650 3750-E CHARTER PARK DR.,SAN JOSE CA 95136-1356 ACKFLOW PREVENTION SPECIALISTS, INC. MAILING/OWNER Maniglia Landscape SERVICE Whole Foods Market Address ADDRESS 250 Commercial St 20955 Stevens Creek Blvd. San Jose,CA. 95112 Cupertino,CA. 95014 CONTACT:Gabriel TEL# 409-392-1649 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Febco 825YA RP 2" H008369 NEW INSTALLATION: REPLACEMENT: REPLACEMENT DEVICE INFORMATION MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER LOCATION OF DEVICE RECEVEE) INTERNAL ❑ METER# 62109776 EXTERNAL® TAG# U Hazard Type:Irrigation PUBLIC WORKS DEPARTMENT REDUCED PRESSURE DEVICES PRESSURE TYPE Shutoff Valves DOUBLE CHECK VALVES VACUUM BREAKERS DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE/RELIEF AIR INLET CHECK VALVE N0.1 N0.2 VALVE Ni N�g2r CLOSEDJGHT CLOSED TIGHT OPENED AT�_LBS. OPENED AT LBS CLOSED TIGHT CLOSED TIGHT❑/L.1 A INITIAL q lbs. �' #lbs. OPENED UNDER 1.0 #LBS. LEAKED ❑ ❑ TEST OPENED UNDER 2.0 DR DID NOT OPEN❑ LEAKED ❑ LEAKED ❑ OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS AND MATERIALS ' USED FINAL CLOSED TIGHT❑ CLOSED TIGHT ❑ CLOSED TIGHT _ TEST gLBS gLBS ❑ OPENEDAT #UIS PENEDAT_# CLOSED TIGHT❑ ❑ NLBS Comments: THE ABOVE REPO C RTIFI E T PASS "ITIAL TEST BV I, CERTIFIED TESTER DATE 06/05/07 FAIL El(il. ER NO. MO. DAY YR. REPAIRED BY DATE PASS ❑ FINAL TEST BY - _ CERTIFIED TESTER NO. DATE FAIL ❑ MO. DAY YR.