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NO PERMIT NUMBER (9) CERTIFICATION OF RE-CLAIMED WATER SYSTEMS CROSS CONNECTION SPECIALISTS BACKFLOW PREVENTION VALVE EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS INSTALLATION-REPAIRS-TESTING-CERTIFICATION • 9y6• BACKFLOW PREVENTION SPECIALISTS, INC. LICENSED CONTRACTOR C.C.L.#427328 CALIFORNIA (800)484-FLOW(3589) 3750•E CHARTER PARK DR.,SAN JOSE CA 95138-1356 (408)269-26M 3808 FERNWOOD ST.,SAN MATEO CA 94403FAX(408)289-2850 SERVICE ADDRESS 19500 Pmneridge Ave.,Cupertino/X-Wolfe I n T 2 9 90n3 MAILING ADDRESS The Hamptons CONTACT Fdgar 19500 Pmneridge Ave. TEL# 873-8800 Cupertino,CA 95014 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Willdns 975XL RP 11/2" 652499 INTERNAL Cl TAG LOCATION OF DEVICE right of carpor 111 irrigation in enclosure EXTERNAL IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX[3 PASS FAIL❑ .- :: r •' REDUCED PRESSURE DEVICES PRESSURE TYPE DOUBLE CHECK VALVES VACUUM BREAKERS RPP VALVES DIFFERENTIAL CHECK VALVE CHECK VALVE PRESSURE/RELIEF. .. ' 40.1 N0.2 VALVE AIR INLET CHECK VALVE � � yyy......��� � � - CLOS DTIGHT Ijl, CLOSED TIOHT, pp OPENED AT O•v LBS. OPENED AT LBS CLOSED TIGHT ❑ INITIAL #Ibs. _/- pIb& #LBS 0LBS. 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 #LEIS OPENED AT_LBS OPENED AT LBS #LBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY ''CERTIFIED TESTER NO.9815 J DATE 10-20-03 .. . ✓<..,f.` c A MO. DAY YR. • REPAIRED BY ' DATE FINAL TEST BY CERTIFIED TESTER NO, DATE MO. DAY YR. I CERTIFICATION OF RE-CLAIMED WATER SYSTEMS ggg��_���'''�����////��r.. '_'��y CROSS CONNECTION SPECIALISTS 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) U ($5896iVEj L 3750-E CHARTER PARK DR.,SAN JOSE CA 95136.1356 (408)269-2600 i 3608 FERNWOOD ST.,SAN MATEO CA 94403 FAX(408)269-2650 SERVICE ADDRESS 1950019500 Pnineridge Ave.,Cu�rtino/X-Wolfe BY;�Ave.,Cu�rtino/X-Wolfe BY4 MAILING ADDRESS The Hamptons CONTACT Edgar 1950019500 Pnlneridge Ave. TEL# 873-8800 Cupertino,CA 95014CA 95014 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Willdns 975 RP 11/2" 595500 INTERNAL ❑ TAG LOCATION OF DEVICE left of basketball court irrigation in enclosun: EXTERNAL IF DEVICE IS ANEW INSTALLATION PLEASE CHECK THIS BOX[3 PASSH] FAIL❑ • 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 y� N0.2 �] ^1 CLOSED TIGHT ql CLOSED TIGHT �7( OPENED ATP•vtBS. OPENED AT_LBS CLOSED TIGHT ❑ INITIAL 9lbs. �`8/ SIL ` itlbs. #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 ❑ OPENEDAT_LBS OPENED AT_LBS CLOSED TIGHT❑ TEST ALBS 4LBS IL8S THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY CERTIFIED TESTER NO. 9815 DATE 10-20-03 MO. DAY YR. • REPAIRED BY DOTE FINAL TEST BY CERTIFIED TESTER NO. DATE MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS CROSS CONNECTION SPECIALISTS BACKFLOW PREVENTION VALVE EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS _,' INSTALLATION-REPAIRS-TESTING-CERTIFICATION BACKFLOW PREVENTION SPECIALISTS, INC. LICENSED CONTRACTOR C.C.L.#427329 CALIFORNIA (800)464-FLOW(3589) 3750-E CHARTER PARK DR.,SAN JOSE CA 95136.1356 (408)269-2600 3908 FERNWOOD ST.,SAN MATEO CA 94403 FAX(408)269-2650 �- SERVICE ADDRESS 19500 Pmnerid a Ave.,Cu rtino/X-Wolfe OCT MAILING ADDRESS The Hamptons CONTACT Edgar 19500PruneridgeAve. TEL# 873-8800 BY: Cu�rtino,CA 95014CA 95014 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER Willdns 975XL RP 11/2" 532158 INTERNAL ❑ TAG LOCATION OF DEVICE prop line 40'from curb carport 21 irrigation EXTERNAL ® in enclosure 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 CHECK VALVE PRESSURE/RELIEF N0.7 N0.2 VALVE AIR INLET CHECK VALVE CLOSEDTIGHT ❑ CLOSED TIGHT ❑ OPENEDAT_LBS. OPENEDAT_LBS CLOSEDTIGHT ❑ INITIAL #lbs. #lbs. #LBS #LBS. TEST �.f OPENED UNDER 2.0 OPENED UNDER 1.0 LEAKED yJ LEAKED ❑ OR DID NOT OPEN ❑ OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS AND /�� MATERIALS ,,I-e GGG��I USED VVV F NAL CLOSED TIGHT❑ CLOSED TIGHT ❑ OPENED AT LBS OPENED AT LBS CLOSED TIGHTEST pLBS #LBS plgg THE ABOVE REPORT IS CERTIFIED TO BE TR/UEE INITIAL TEST BY���{'�CERTIFIED TESTER NO, 9815 DATE 10-20-03 MO. DAY YR. • REPAIRED BY DATE FINAL TEST BY CERTIFIED TESTER N0, DATE MO. DAY YR. CERTIFICATION OF RE-CLAIMED WATER SYSTEMS CROSS CONNECTION SPECIALISTS BACKFLOW PREVENTION VALVE EXPERT CERTIFIED CROSS CONNECTION CONTROL CONSULTANTS, INSTALLATION-REPAIRS-TESTING-CERTIFICATION • 9� BACKFLOW 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 3608 FERNWOOD ST.,SAN MATEO CA 94403 FAX(408)269-2650 SERVICE ADDRESS 19500 Pnlneridge Ave.,Cu rtino/X-Wolfe MAILING ADDRESS ne Hamptons CONTACT Edgar I 19500PnieridgeAve. TEL# 873-8800 Cupertino,CA 95014CA 95014 MANUFACTURER MODEL NUMBER TYPE SIZE SERIAL NUMBER WiWins 975 RIP 11/2" 595894 INTERNAL Cl TAG LOCATION OF DEVICE next to carport 146 irrigationinenclosure 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 CHECKVALVE CHECKVALVE PRESSURE/RELIEF N0.1 N0.2 VALVE AIR INLET CHECK VALVE CLOSEDTIGHT ❑ CLOSED TIGHT ❑ OPENEDAT_LBS. OPENEDAT_LBS CLOSEDTIGHT ❑ INITIAL #lbs. #Ibs. #LBS #LBS, TEST OPENED UNDER 2.0 OPENED UNDER 1.0 LEAKED I LEAKED ❑ OR DID NOT OPEN ❑ OR DID NOT OPEN ❑ LEAKED ❑ REPAIRS C��eCC AND MATERIALS L v )' USED / FINAL CLOSED TIGHT❑ CLOSED TIGHT ❑ OPENED AT_LBS OPENED AT_LBS CLOSED TIGHT El TEST #LBS #LBS #LBS THE ABOVE REPORT IS CERTIFIED TO BE TRUE INITIAL TEST BY CERTIFIED TESTER NO.9815 DATE 10-20-03 MO. DAY YR. REPAIRED BY DOTE FINAL TEST BY CERTIFIED TESTER NO, DATE MO. DAY YR.