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Backflow Report-2002CERTIFICATION OF RE-CLAIMED WATER SYSTEMS CROSS CONNECTION SPECIALISTS BACKFLOW PREVENTION CERTIFIED CRO,....�S CONNECTION CONTROL CONSULTANTS ,,,,,.,. VALVE EXPERT INSTALLATION -REPAIRS -TESTING -CERTIFICATION PRESSURETYPE TEL# (650) 280-0048 %ACKFLOW PREVENTION SPECIALISTS, INC. LICENSED CONTRACTOR C.C.L.# 427328 MANUFACTURER CALIFORNIA (800) 484 -FLOW (3589) 3750-E CHARTER PARK DR., SAN JOSE CA 95136.1356 (408) 269-2600 1522-A DAY AVE., SAN MATEO CA 94403 825YA FAX (408) 269-2650 lwza INTERNAL ❑ TAG LOCATION OF DEVICE main SERVICE ADDRESS 1621 Toree Ave., Cupertino EXTERNAL IIS,.^-+� VALVE • MAILING ADDRESS Tishman Speyer REDUCED PRESSURE DEVICES CONTACT AllthOnY 444 Castro St., Ste. 520 PRESSURETYPE TEL# (650) 280-0048 Mountain View, CA 94041 VACUUM BREAKERS MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Febco 825YA RP 2" BG2012 INTERNAL ❑ TAG LOCATION OF DEVICE main N0.1 EXTERNAL IIS,.^-+� VALVE '•'� CHECK VALVE OCT 0 9 2002 OPENED AT Z_O LBS. IF DEVICE IS A NEW BOX❑ PASSIA FAIL❑ THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY CERTIFIED TESTER NO. "' DATE REPAIRED BY����-� • DAT n FINAL TEST BY CERTIFIEDTESTERNO, DATE 09-26-02 MO. DAY YR. MO. DAY YR. REDUCED PRESSURE DEVICES PRESSURETYPE DOUBLE CHECK VALVES VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECKVALVE CHECK VALVE PRESSURE I RELIEF N0.1 N0.2 VALVE AIR INLET CHECK VALVE CLOSED TIGHT CLOSED TIGHT ejr— OPENED AT Z_O LBS. OPENED AT _ LBS CLOSED TIGHT ❑ INITIAL klbs._ " Albs. #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 Cl CLOSED TIGHT ❑ CLOSED TIGHT TEST #LBS #LBS OPENED AT LES OPENED AT_LBS #LBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY CERTIFIED TESTER NO. "' DATE REPAIRED BY����-� • DAT n FINAL TEST BY CERTIFIEDTESTERNO, DATE 09-26-02 MO. DAY YR. MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS CERTIFIED.CB¢SS CONNECTION CONTROL CONSULTANTS���9'i %ACKFLOW PREVENTION S CROSS CONNECTION SPECIALISTS BACKFLOW PREVENTION VALVE EXPERT INSTALLATION -REPAIRS -TESTING -CERTIFICATION PECIALISTS, 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 1522-A DAY AVE., SAN MATEO CA 94403 FAX (408) 269-2650 ,row/ SERVICE ADDRESS 192fToree Ave., Cupertino MAILING ADDRESS Tishman Speyer CONTACT AnthOriy 444 Castro St., Ste. 520 TEL# (650) 280-0048 Mountain View, CA 94041 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Watts 909 RP 11/2" 175087 INTERNAL TAG LOCATION OF DEVICE irrigation EXTERNAL ❑ IF DEVICE IS ANEW INSTALLATION PLEASE CHECKTHIS BOX PASSIX FAIL❑ THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY ��^�'� CERTIFIED TESTER NO. REDUCED PRESSURE DEVICES DATE 09-26-02 PRESSURE TYPE DOUBLE CHECK VALVES YR. VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE / RELIEF VALVE AIR INLET CHECK VALVE NO.1 NO.2 CLOSED TIGHT 2r CLOSED TIGHT— OPENED AT 3l1 LBS. OPENED AT_LBS CLOSEDTIGHT ❑ INITIAL #lbs. #Ibs. #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 Cl CLOSED TIGHT ❑ CLOSED TIGHT ❑ OPENED AT LBS OPENED AT LBS TEST # LBS #LBS _ _ # LBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY ��^�'� CERTIFIED TESTER NO. ZG S� DATE 09-26-02 MO. DAY YR. 9 REPAIRED BY FINAL TEST BY DATE CERTIFIED TESTER NO. DATE MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS CROSS CONNECTION SPECIALISTS CERTIFIED -GROSS CONNECTION CONTROL CONSULTANTS 1�� BACKFLOW PREVENTION VALVE EXPERT �., INSTALLATION -REPAIRS -TESTING -CERTIFICATION %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 1522-A DAY AVE., SAN MATEO CA 94403 FAX (408) 269-2650 • SERVICE ADDRESS 10201 Torree MAILING ADDRESS Tishman Speyer CONTACT Anthony 444 Castro St., Ste. 520 Mountain View, CA 94041 MANUFACTURER MODELNUMBER TYPE Wilkins 975XL RP INTERNAL ® TAG EXTERNAL ❑ TEL# 650-280-0048 LOCATION OF DEVICE Boiler Room Roof SIZE SERIAL NUMBER 3/4" 1232026 IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX PASS® FAIL❑ THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY 0 REPAIRED BY FINAL TEST BY CERTIFIED TESTER NO. 2656 DATE 9/26/02 MO. DAY YR. DATE CERTIFIED TESTER NO. DATE MO. DAY YR. REDUCED PRESSURE DEVICES PRESSURE TYPE DOUBLE CHECK VALVES. VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE/RELIEF VALVE AIR INLET CHECK VALVE N0.1 N0.2 CLOSED TIGHT-® CLOSED TIGHT ® OPENED AT 3.0 LBS. OPENEDAT_LBS CLOSEDTIGHT ❑ INITIAL a ms. 9.6 # 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❑ OPENED AT_LEIS OPENED AT_LEIS TEST I #LBS I #LBS It IBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY 0 REPAIRED BY FINAL TEST BY CERTIFIED TESTER NO. 2656 DATE 9/26/02 MO. DAY YR. DATE CERTIFIED TESTER NO. DATE MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS CROSS CONNECTION SPECIALISTS EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTSy BACKFLOW PREVENTION VALVE INSTALLATION -REPAIRS -TESTING -CERTIFICATION �wC[ats�9s6• *BACKFLOW PREVENTION SPECIALISTS, INC, LICENSED CONTRACTOR C.C.L.# 427328 CALIFORNIA (800) 464 -FLOW (3569) (408) 269-2600 3750-E CHARTER PARK DR., SAN JOSE CA 95136-1356 FAX (408) 269-2650 1522-A DAY AVE., SAN MATEO CA 94403 CHECKVALVE • SERVICE ADDRESS 10201 Torree Ave., Cupertino MAILING ADDRESS Tishman Speyer CONTACT Anthony 444 Castro St., Ste. 520 TEL# 650-280-0048 Mountain View, CA 94041 MANUFACTURER MODELNUMBER TYPE SIZE SERIAL NUMBER Wilkins 975XLSE RP 3/4„ 1236914 INTERNAL ® TAG LOCATION OF DEVICE Cooling Tower Roof EXTERNAL ❑ IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX PASS® FAIL❑ THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY CERTIFIED TESTER NO. 2656 DATE 9/26/02 MO. DAY YR. • REPAIRED BY FINAL TEST BY DATE CERTIFIED TESTER NO. DATE MO. DAY YR. REDUCED PRESSURE DEVICES PRESSURE TYPE DOUBLE CHECK VALVES VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECK VALVE CHECKVALVE PRESSURE/RELIEF VALVE AIR INLET CHECK VALVE N0.1 N0.2 CLOSED TIGHT ® CLOSED TIGHT ® OPENED AT 3.0 LBS. OPENEDAT_LBS CLOSEDTIGHT ❑ INITIAL # lbs. 10.0 # 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 OPENED AT LBS TEST #LOS #LBS _LBS _ #LBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY CERTIFIED TESTER NO. 2656 DATE 9/26/02 MO. DAY YR. • REPAIRED BY FINAL TEST BY DATE CERTIFIED TESTER NO. DATE MO. DAY YR.