Loading...
HomeMy WebLinkAbout6932 Autumn Ridge Dr - Special Inspections/Backflow - 10/23/200310/31/2003 10:53 Oct 31 03 07:20a 9706350426 ALRM FIMALEY BELMIRE PAGE 03 970-813-1309 P.2 LOVELAM PLUMING — 1022 West 33`' Street Loveland, CO 80538 BACKFLOW INSPEMON SERVICE - 970-667-9971 BACKFLOW PREVENTION ASSEMBLY TEST AND MAIN'I`ENANCE REPORT Customer must retain a copy of this report for a minimum of three years Water Di%4Ct/AU[1% 'b CITY OF FT. COMM -- Service Name K Service Address: M2 Contact Perm Tide' FT Owner/Contra t/Maaager HEI MME SPRINIQ.BR / LANDSCAPING, INC. Mailing A4 ress: P.O. BOX 7932 LOVELAM, CO $0537 Canna Fawn:-- JPY Title New■ Use: Existing❑ Re placernent For: Domestic ❑ Fire© Irriptiou 0 Phvae 970-667-7775 _ Asnabl'y T'Fpe: Ra hiced Press n ❑ Amble Check © Pmmm Vacuum BmakerN other — Mfg.: FEBCO Model No.: 765 Size: 3/4 Serial No.: H125837 Date Installed: Lest IhVecdoa: N/A Line A'e;ssum 55 PST Loch : NORTH SIDE Initial Test ReaWt Comments Re -Teat Re wits TWMW DWOW4W T tN Check No 1 Lek 2 4 LN& xP 0c: rvs TWd Tot ctadc No 2 Letl< B Lode tX7 T TWO RellofVu1Vt; y. Buffer+' Air rntCt 3.2 shnEotrvAvcNa 1 Ls* ❑ T+s� Shut-off vdw No. 2 Lak Q rik (] ASSW TEST USED: S010-1013-1 5010-1015-2 5010-1020-1 X 5010- Rgwirs/Commetus: NO BA,CURESSM Assembly Me chasical Test: RaaAed ■ hiked 0 ffmoolraio l sac Weis eLs w,s.r FurvCn*+ �r �t be nali�'ied i s rerjtb• n.do as an u pwaibI& Techwam ecxtities this assembly hens bm tcSMd in accordawe with ASSE Procedures Test Tochni u: Alen t�tudky CernScation No.: 2324 FxplreS: 12/31/04 3ipatm= TcA Date: t nM3 .403 Time: 1PM -- Phatte: 97"67-8971 Tes Gauge Model: WAITS IX99F Gage Re-Ce rt Date: 5/01104