Backflow Certification r '
Cal-Air, Inc.
1555 South Seventh St.
• SAF J " _ Safi Jose, CA 95112
Ph. (408) 283.2300
Pax. (408) 293.9511
Lkk1]it95
BACKFLOW CERTIFICATION
SERVICE ADDRESS: /0300 TQ h+4 4 cu p v�4ii,o - In-pP4 3149
DEVICE LOCATED:
RETURN TO: ACCT NO. METER NO.
Mailing AddressRMATIOW tf
Type 12P Size I_ MFG WA- r
Model(�'�M2.GLT SER.NO p4iqlaq2
,TYPE OF SERVICE
I❑I� DOMESTIC ❑ IRRIGATION
CONTACT: L2y' INDUSTRIAL ❑ FIRE
Job Number REPORT OF TEST RESULTS ❑ PASS ❑ FAIL
. . ,,......._..W.. -.rt.
REDUCED REDUCED ASSEMBLY �.PRESSURE-VACUUM BREAKER'•L�i
DpOUBLE CHECK Air Inlet Check Valve
� n� tU ,t�pI�CH¢6KUALVEt1{{+ },a' HEOK�VALVE•�nN� l[jH�+ l7f�' RELIEF+'" 21( R•Opened at Closed Tight
pti'kp5t' yd„(ir trte-«'t(°I=r rr 1^ 'tt=8y 4 drttrfn U, n') i �I i
" ,�6 �ra10 x rp lUwrN0,1, � t��IK�w�u TN0.29, Ii2 't�M�VALVE�ifihh. PSID
,ry,o rft CLOSED TIGHT CLOSED TIGHT OPENED AT z.S( PSID PSID
I INITIAL,
r1'11. t rfi LEAKED LEAKED ❑ B Opened Under 1.0 PSID
d�t
T Did Not Open ❑ Leaked
4
' .'.yyyt , is PSID qi•L ® CLOSED TIGHT UNDER 2.0 PSI ❑ ,?fl,lr�ll�YSHUT-0FF=VALVEigwW'{bi
LEAKED ❑ LEAKED DID NOT OPEN NO.1 NO.2
IM..r) j+A'�rf CLEANED CLEANED LJ CLEANED ❑ ❑ LEAKED ❑
❑ CLOSED TIGHT ❑
;. .
i REPLACED ❑ REPLACED ❑ REPLACED ❑ -
uV.ol'r d DISC ❑ DISC ❑ DISC(S) ❑ ❑ CLEANED ❑
� �,fit {iJxn'srU'.In#i SPRING ❑ SPRING ❑ SPRING ❑
hY�•*-=+�"rfb b'' 'GUIDE ❑ GUIDE ❑ DIAPHRAGM(S) ❑ REPLACED ❑
SEAT ❑ SEAT ❑ SEAT(S)
MODULE ❑ MODULE ❑ O-RINGS ❑ Replaced With
{,1 `I
N ' ., f lt, OTHER ED OTHER ❑ MODULE ❑
ti i,] is
T .
: OTHER Type
a ;�.FINAI[tF CLOSED„dTIGHT CLOSED TIGHT OPENEDAT s1;,�L-a,ua'= ;1, f(• �. PSID. �•1 PSID z � PSID Mf
.8? TESTr..
Note:Please keep in your files for 3 years.
THE ABOVE REPORT IS CERTIFIED TO BE TRUE:
REPAIRED BY: /n1� DATE:
�
FINAL TEST BY: ' 1yk1 s CERTIFIED TESTER NO. 104,06'2- DATE: 3-19-011
COMMENTS: IkQ - . J. — QCtQ- - Cl+t ll dr rbonW
. d
Foster City Glendale Los Angeles Sacramento San Francisco Santa Rosa
Fresno Livermore Oirenge S¢m pied,, San Jose 3alir= Whither Onlatio
Cal Air, Inc.
1555 South Seventh St.
Lr �� San Jose, CA 95112
+ Ph. (408) 283.2300
rax. (408) 293.9511
Lie 0151195
BACKFLOW CERTIFICATION
SERVICEADDRESS: /0300 7-Q4A7Yu F etApe,--j-fNo wit,,
DEVICE LOCATED: `1;i4 rV0'
RETURN TO: ACCT NO. METER NO.
....„„e. .,..6l
Mallin Address �'l;k�"�5�i?%:iF<?iV�DEVICE'�.INFORMATION� T"iti!i,F1
Type Size 314'1 MFG IdATrS
Model O()q-YV1 aii SER.NO AOS I I lY
TYPE OF SERVICE
❑ DOMESTIC ❑ IRRIGATION
CONTACT: INDUSTRIAL ❑ FIRE
Job Number REPORT OF TEST RESULTS PASS ❑ FAIL
REDUCED REDUCED ASSEMBLY ><i#1?PRESBURE= � Ii
�,VACUUM.BREAKEi
DOUBLE CHECK Air Inlet Check Valve
""1nit° CHECK VALVE 'CHECK VALVE i+b `nis)j RELIEFS " 7 I Opened at Closed Tight
)i+ Iddt Nr tt�fl lf � r„nN0.11{� a Irl (NO 3S.irY{(us +! V Sa 1�.VALV6.a1�1 : vt31 PSID
• ;I'•"I91`r`+';"$ ,�1.}CLOSED TIGHT CLOSED TIGHT OPENED AT Z-- PSID PSID
14i iNl'rIAL IS LEAKED ❑ LEAKED ❑ Opened Under 1.0 PSID
+ TEST+
Did Not Open ❑ Leaked
1
001,
J PSID t'7 L^J CLOSED TIGHT ❑ UNDER 2.0 PSI ❑ "r`' i n+ I'"'� '6rkY�"+-` A
sq n. , z,��'� SHUT_-0FF VALVE �.el;Yckpd..
r � , LEAKED ❑ LEAKED ❑ DID NOT OPEN NO.1 NO.2
y� ❑ ❑
S!`fit, CLEANED CLEANED CLEANED ❑ LEAKED
2t'tF" f ,! ❑ CLOSED TIGHT ❑
�> r' h REPLACED ❑ REPLACED ❑ REPLACED
,•, t_k{ DISC ❑ DISC ❑ DISC(S) ❑ ❑ CLEANED ❑
"^'i0" j -SPRING ❑ SPRING ❑ SPRING
REPAIRSt�4� ❑
� $I`tit7` ; "> GUIDE ❑ GUIDE ❑ DIAPHRAGM(S) ❑ ❑ REPLACED ❑
`nlr SEATSEAT ❑ SEAT(S) ❑
MODULE ❑ MODULE ❑ O-RINGS ❑ Replaced With
f{u) tE' 1 OTHER ❑ OTHER ❑ MODULE ❑
s.+-:...,.., OTHER Type
FIWA�''tt" j, CLOR sgD TIGHT CLOSED TIGHT OPE�EAT
u:. ;, 9 J
TEST,e!#h,Pi PSID PSID PSID Mf
Note:Please keep in your files for 3 years.
THE ABOVE REPORT IS CERTIFIED TO BE TRUE:
REPAIRED BY: C+ DATE:
FINAL TEST BY: S CO't-E BU1lil S CERTIFIED TESTER NO. 10(a62— DATE: - 1411-Oct
COMMENTS: #p- q.y " 140'01C18oiler roDen
•
Foster Cily Glendale Los Angeles Sacramento Sari Francisco Santa Rosa
Fresno Livermore Orange San Uii San Jose Salinas Whittier Ontario
Cal-Air, Inc.
h 1555 South Seventh St.
San Jose, CA 95112
Ph. (408) 283.2300
rax. (408) 293.9511
' Lk/n1196
BACKFLOW CERTIFICATION
SERVICE ADDRESS: !o 300 Tau.-Fa u. fpei�lnr: — A"'Q Pit ��d q
DEVICE LOCATED:
RETURN TO: ACCT NO. METER NO.
Mailing Address GyRFy„:iik�DEVICEINFORNIATIONi''�'tro"r K` !'
Type P P _Size 1 5 MFG w
Model 0OgWI2 01" SER.NO A039551
TYPE OF SERVICE
❑ DOMESTIC ❑ IRRIGATION
Iii—INDUSTRIAL
CONTACT: ❑ FIRE
Job Number REPORT OF TEST RESULTS ®' PASS ❑ FAIL
REDUCED REDUCED ASSEMBLY itNAPRESSURFVACUUM BREAKER.""t
DOUBLE CHECK Air Inlet Check Valve
�F{t2' d"� �1"i " CHECKS ArLVEI i £t OHECKVALVEj�r °! 'Y`tfr i?,',RELIEF1`I'�i j �ilZei i Opened at Closed Tight
yyr
wt ai n`xXi3 r.t
�G 1�v,No.a' { #k: a, 111;,' No.24 IC�i .:,�tvaLVE� 4� � G PSID
• ;'g'+ CLOSED TIGHT CLOSED TIGHT OPENED AT 2, PSID PSID
qX' INITIAL l LEAKED LEAKED ❑
p nan ,r Opened Under 1.0 PSID
1 TESTa ` P, B Did Not Open ❑ Leaked
4
� p� w, PSID �' 7V CLOSED TIGHT ® UNDER 2.0 PSI ❑ RMr,"1m 4`�SHUT-04,,U E�i'�.+�G�'11;5
�i ,. X' LEAKED LEAKED ❑ DID NOT OPEN El LEAKED
NO.2
)( i CLEANED CLEANED CLEANED ❑ LEAKED
�f
,. ❑
P ^g 4'i
CLOSED TIGHT
`1j+oS REPLACED ❑ REPLACED REPLACED ❑
Mi r."a'' DISC ❑ DISC ❑ DISC(S) ❑ ❑ CLEANED ❑
Y.
REPAIRSTItti SPRING ❑ SPRING ❑ SPRING ❑
{�Iui��? GUIDE ❑ GUIDE ❑ DIAPHRAGM(S) ❑ ❑ REPLACED ❑
+ jr7i2} P i,lilg SEAT ❑ SEAT ❑ SEAT(S) ❑
•,��iANi
n
MODULE ❑ MODULE ❑ O.RINGS ❑ Replaced With
a� OTHER ❑ OTHER ❑ MODULE
OTHER Type
IGIFINAL4" CLOSED TIGHT CLOSED TIGHT JOPENEDAT
f" IItiTEST+,Xv PSID �_ PSID z.s PSID
Mf
Note:Please keep in your files for 3 years.
THE ABOVE REPORT IS CERTIFIED TO BE TRUE:
REPAIRED BY: DATE:
FINAL
FINAL TEST BY: Scott UNr S CERTIFIED TESTER NO. 10(06'2— DATE: 3.19- O 9
COMMENTS: AP' �' �°yolrny "'row2R 63CLCK Pad
•
Fostor City Glendale Los Angeles Sacramento San Francisco Santa Rosa
Fresno Liwrmoie Gmnge, SanPicgo San josa SaIvIU5 Whittier Ontario
Cal-Air, Inc.
• C � v 1555 South Seventh St.
San Jose, CA 95112
' ' +� Ph. (408) 283.2300
Pax. (408) 293.9511
Lkk 1]119]
BACKFLOW CERTIFICATION
SERVICE ADDRESS: /0300 -r K+Qtw LCAPel+rt
DEVICE LOCATED: 'TrgaTyt4
RETURN TO: ACCT NO. METER NO.
Mailing Address
�DEVPCEIN",.•.•.•.� ...•.. �" {(«4r`.tilAvRjl+v
,.n,r n]i.aEti
Type RLP Size 2 ✓I MFG tbCO
Model g 2S_Lf SER.NO SO 1 3
TYPE OF SERVICE
❑ DOMESTIC ®, IRRIGATION
CONTACT: ❑ INDUSTRIAL ❑ FIRE
Job Number REPORT OF TEST RESULTS ErIPASS ❑ FAIL
141p„ , ._......,..•, »�,,,..,„..............:.......fin
REDUCED REDUCED ASSEMBLY - ' ((je,.PRESSURE.VACUUM'BREAKERu+Id
DOUBLE CHECK Air Inlet Check Valve
'� 1 �' ' "CHECKVALVE s f�`CNECK VALVE 'r d FE"'I't` 'RELIEFi�.• Y i Opened at Closed Tight
nr' 1 a w i +iti i :{{3 a . yy��,,pc f',fltsa�
affj✓ta a f.! t�td'tiT"'rN0.1� '6a,�EiP. iH 'u3 i NO2�1W.3g i 'It? LVAWEI�o 4j4lar t PSID
• '1 I'r� 'l +ICIi r`I CLOSED TIGHT CLOSED TIGHT OPENEDAT z PSID PSID
INITIi( LEAKED ❑ LEAKED ❑
8
yTEST Opened Under 1.0 PSID
"
Did Not Open ❑ Leaked
'{}��'+ t,n PSID CLOSED TIGHT Ll UNDER 2.0 PSI ❑ dw a r'd SHUTAF•F'VALVE A1tiv001 1
V,, LEAKED - ❑ LEAKED El DID NOT OPEN - NOA NO.2
r� 4fE r, CLEANED CLEANED CLEANED ❑
„VJj ❑ ❑ LEAKED
g,• ❑ CLOSED TIGHT ❑
REPLACED ❑ REPLACED ❑ REPLACED ❑
* t I- a DISC ❑ DISC ❑, DISC(S) ' ' ❑ ❑ - CLEANED ❑
SPRING ❑ SPRING ❑ SPRING
REPAIRS.' ❑
;%;+�IGUIDE ❑ GUIDE ❑ DIAPHRAGM(S) ❑ .❑ REPLACED ❑
! J
�SEAT El SEAT LJ SEAT(S) ❑
1 r!•,; { y {t��t MODULE ❑ MODULE ❑ O-RINGS ❑ - Replaced With
OTHER ❑ OTHER ❑ MODULE ❑
nJ
I OTHER Type
.INAL�'10'` r CLOSED TIGHT CLOSED TIGHT OP NE AT
Ned°mn j
�j
!:aiE3i�'iFTEST .,q'it PSID S PSID /. PSID - Mf ,
Note:Please keep in your files for 3 years.
THE ABOVE REPORT IS CERTIFIED TO BE TRUE: - ,
REPAIRED BY: �+ DATE: ]4
FINAL TEST BY: Scott Q/^CJUI'1 g CERTIFIED TESTER NO.. 10(052—
OIOSZ .DATE:. J——/1 69
COMMENTS:
• AP
Foster City Glendale Los Angeles .Sacramento San Francisco Santa Rosa
Fresno Livermore Orange San Uiel,7o 4 San Jose. Salinas ,Whittler . •Ontario
Cal-Air, Inc.
1555 South Seventh St.
San Jose, CA 95112
Ph. (408) 283.2300
Pax. (408) 293.9511
- Lk 1151155
BACKFLOW CERTIFICATION
SERVICE ADDRESS: /0300 -iAn-t✓4 (L�i, , p� .� �dO
DEVICE LOCATED: 'r4"rmi*
RETURN TO: ACCT NO. METER NO.
Mallin Address - '(( }'rJS';ih3ilr`i'DEVICEINFORMATION.Ir?i}l�113rliili ,J.�,,.
Type Siz
re- /1 MFG W li`
Model [poo k-,,O V7 SER.NO/ OZ
TYPE OF SERVICE
DOMESTIC ❑ IRRIGATION
CONTACT: INDUSTRIAL ❑ FIRE
Job Number REPORT OF TEST RESULTS ❑ PASS ❑ FAIL
.......,a,.y,.,,...,_,,,,,,u................. -
REDUCED REDUCED ASSEMBLY ri}tI�PRESSURE:VA000M:BREAKERliI??
DOUBLE CHECK Air Inlet Check Valve
4g' �kKf'T''J�gCHECK VALVE i+>§ ` CHECK VALVES,r ^ T"J ,�rRELIEF h%' Opened at Closed Tight
�..u'J"IaEi +yJal iYih,'-N0,1 ny is'P"L`1# 3,,�NOI�581"i�]fi �4�.t1`?+� i)VALVE tiIF,II�'�t.itsa PSID
• P� h� (yf� CLOSED TIGHT CLOSED TIGHT OPENED AT PSID PSID
�lv�yINITIAb 114 LEAKED ❑ LEAKED
❑
' ;I',ikyyyk yy e Opened Under 1.0 PSID
Did Not Open ❑ Leaked
P
If�ll SID CLOSEDTIGHT❑ ❑ UNDER 2.0 PSI ❑ , ? ��rtSHUT=O FiVALVEM�.. >G�,'401
u 4y,°
'5� � 1C LEAKED DILE ❑ DID NOT OPEN NO.1 N0.2
CLEANED CLEANED LJ CLEANED ❑ ❑ LEAKED ❑
i " ?Y`i4nNi rz': ft ❑ CLOSED TIGHT ❑
y r �'`A51A
`t 'It't�i(}y,li4, r REPLACED ❑ REPLACED ❑ REPLACED ❑
4 DISC ❑ DISC ❑ DISCS ❑ ❑
_ � i T'�? DISC(S) ❑ CLEANED
I i^ r SPRING ❑ SPRING ❑ SPRING ❑
RERAtRS
GUIDE ❑ GUIDE ❑ DIAPHRAGMS) ❑ ❑ REPLACED ❑
...
M SEAT ❑ SEAT ❑ SEAT(S) ❑
- � Ir''1'ari�rc lIj�r MODULE ❑ MODULE ❑ O•RINOS ❑ Replaced With
OTHER OTHER Sin 4C ❑ ❑ MODULE ❑
.4ltrvr:�Is}tr..,t
Q OTHER Type
i,'=1ffkkALtW CLOSED TIGHT CLOSED TIGHT OPENEDAT
$ as;
PSID PSID PSID Mf
Note:Please keep in your files for 3 years.
THE ABOVE REPORT IS CERTIFIED TO BE TRUE:
REPAIRED BY: DATE:
FINAL TEST BY: .5rcTT BIAI.Lts CERTIFIED TESTER NO. 10652- DATE: 3'19 -0�{ .
COMMENTS: "rwye rl mdmor,a If-0,040p of 77�,Ot -AAP rd-h, -
•
Foster City Glendale Los Angeles Sacramento San Francisco Santa Rosa
Fresno Livermore Orange San Dirno San Jose Salinas Whittier Ontario