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Backflow Report-2004CERTIFICATION OF RE-CLAIMED WATER SYSTEMS ._. .�- CROSS CONNECTION SPECIALISTS BACKFLOW PREVENTION VALVE EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS -. �.��:, INSTALLATION -REPAIRS -TESTING -CERTIFICATION ' PRESSURE TYPE %ACKFLOW PREVENTION SPECIALISTS, INC, LICENSED CONTRACTOR C.C.L.# 427328 CALIFORNIA (800) 464 -FLOW (3569) (408) 269-2800 3750-E CHARTER PARK DR., SAN JOSE CA 95136.1356 1522-A DAY AVE., SAN MATEO CA 94403 FAX (408) 269-2850 L SERVICE ADDRESS MAILING ADDRESS Tishman SpeyerProperties 3975 Freedom Cir., Ste. 150 Santa Clara, CA 95054 MANUFACTURER MODEL NUMBER TYPE Willdns 975XLSE RP INTERNAL ® TAG LOCATION OF DEVICE EXTERNAL ❑ CONTACT TEL# (650) 280-0048 tower roof SIZE 3/4" IF DEVICE IS A NEW INSTALLATION PLEASE CHECK THIS BOX❑ PASSiFAIL❑ SERIAL NUMBER 1236914 THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BYCERTIFIED TESTER NO. 4 0a D 6 DATE 9-20-04 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 CHECK VALVE PRESSURE/RELIEF VALVE AIR INLET CHECKVALVE NOA NO.2 CLOSED TIGHT CLOSED TIGHT Of OPENEDATULBS. OPENEDAT_LBS CLOSED TIGHT ❑ INITIAL # lbs. # 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 OPENEDATLBS _ OPENED AT _LBS *LBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BYCERTIFIED TESTER NO. 4 0a D 6 DATE 9-20-04 MO. DAY YR. • REPAIRED BY FINAL TEST BY DATE CERTIFIED TESTER NO. DATE MO. DAY YR. CRSS CONNECTION SPECIALISTS CERTIFICATION OF RE-CLAIMED WATER SYSTEMS BACKFLOW PREVENTION VALVE EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS �.',�•, INSTALLATION -REPAIRS -TESTING -CERTIFICATION %ACKFLOW PREVENTION SPECIALISTS, INC, C J LICENSED CONTRACTOR C.C.1-1 427328 3750-E CHARTER PARK DR., SAN JOSE CA 95136-1356 1522-A DAY AVE., SAN MATEO CA 94403 SERVICE ADDRESS 10201 TOrfC MAILING ADDRESS Tishman Speyer Properties 3975 Freedom Cir., Ste. 150 Santa Clam, CA 95054 MANUFACTURER MODEL NUMBER TYPE Wilkins 975XL RP INTERNAL ® TAG EXTERNAL ❑ CALIFORNIA (800) (408) 269-2800 FAX (408) 269-2650 CONTACT AnthonY TEL# (650)280-0048 LOCATION OF DEVICE boiler room roof SIZE SERIAL NUMBER 3/4" 1237026 IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX [3 PASS AIL❑ THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY� ERiiRED TESTER NO. C�a�d DATE 9-20-04 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 CHECK VALVE PRESSURE / RELIEF VALVE AIR INLET CHECK VALVE NO.1 NO.2 CLOSED TIGHT CLOSED TIGHT OPENEDAT�rrLBS. OPENEDAT_LBS CLOSED TIGHT ❑ INITIAL albs. 10.1) 0Ibs. #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 TEST #ISS ALBS _ _UBS tLBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY� ERiiRED TESTER NO. C�a�d DATE 9-20-04 MO. DAY YR. • REPAIRED BY FINAL TEST BY DATE CERTIFIED TESTER NO. DATE MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS _"!4;y CROSS CONNECTION SPECIALISTS BACKFLOW PREVENTION VALVE EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS . , :r',,. .T. i INSTALLATION -REPAIRS -TESTING -CERTIFICATION %ACKFLOW PREVENTION SPECIALISTS, INC. 464, FLOW (3569)-' ;7 LICENSED CONTRACTOR C.C.L.# 427328 CALIFORNIA (800) 4V.EL 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 I SEP 2 8 2004 • SERVICE ADDRESS 10201 Tone Ave., Cupertino f''Y: MAILING ADDRESS Tishman Speyer CONTACT ArlthonY 3975 Freedom Cir., Ste. 150 TEL# (650) 280-0048 Santa Clara, CA 95054 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 CHECK THIS BOX[] PASS YC FAIL❑ THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY �J� CERTIFIED TESTER NO. b �^ d DATE 9-20-04 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 NO.1 NO.2 VALVE AIR INLET CHECK VALVE CLOSED TIGHT CLOSED TIGHT OPENEDAT�,LBS. OPENEDAT_LBS CLOSED TIGHT ❑ INITIAL 0Ibs. 7. vbs. #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 4LBg OPENEDAT_LBB OPENED AT _ LBS SLBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY �J� CERTIFIED TESTER NO. b �^ d DATE 9-20-04 MO. DAY YR. • REPAIRED BY FINAL TEST BY DATE CERTIFIED TESTER NO. DATE MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS „�se!�°tl;�,.°!W4, CROSS CONNECTION SPECIALISTS -g ♦- BACKFLOW PREVENTION VALVE EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS - �._,� INSTALLATION -REPAIRS -TESTING -CERTIFICATION %ACKFLOW PREVENTION SPECIAL LICENSED CONTRACTOR C.C.L.# 427328 CALIFORNIA (800) 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 Toree Ave., Cupertino MAILING ADDRESS Tishman Speyer 3975 Freedom Cir., Ste. 150 Santa Clara, CA 95054 MANUFACTURER MODELNUMBER TYPE Febco 825YA RP INTERNAL ❑ TAG EXTERNAL LOCATION OF DEVICE main CONTACT Anthony TELA (650) 280-0048 SIZE SERIAL NUMBER 21, BG2012 IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX[] PASSM FAIL❑ I Rt ABUVt KtPVKI R UtR I IVIED TO BE TRUE INITIAL TEST BYf%.!�i REDUCED PRESSURE DEVICES n CERTIFIED TESTER NO. GATE 9-20-04 PRESSURE TYPE DOUBLE CHECK VALVES VACUUM BREAKERS YR. RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE I RELIEF N0.1 N0.2 VALVE AIR INLET CHECK VALVE INITIAL CLOSED TIGHT #lbs. CLOSED TIGHT lbs. n OPENEDAT"(w LBS. OPENEDAT_LBS- #LBS CLOSED TIGHT ❑ ALBS, TEST OPENED UNDER 2.0 OPENED UNDER 1.0 LEAKED ❑ LEAKED Cl OR DID NOT OPEN ❑ OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS AND MATERIALS USED FINAL CLOSED TIGHT ❑ CLOSED TIGHT ❑ CLOSED TIGHT❑ TEST #LBS #LBS OPENEDAT_LBS OPENED AT LBS _ 1LBS I Rt ABUVt KtPVKI R UtR I IVIED TO BE TRUE INITIAL TEST BYf%.!�i 1•L�-'"`�/'// n CERTIFIED TESTER NO. GATE 9-20-04 MO. DAY YR. • REPAIRED BY FINAL TEST BY DATE CERTIFIED TESTER NO. DATE MO. DAY YR.