HomeMy WebLinkAbout6721 Brittany Dr - Special Inspections/Backflow - 04/18/2003,-ui-u4-000L rKl ►e.11 NM FORT COLLINS UTILITIES 9704162442 P. 01
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Existing: 0 Nevr.X Replacement Fars
USEi Domestic: 0 First 0 Irrigatlon: ;'Rfsd�l— t_ ion: (J Containmenla 0
Device type: Reduced ►essurb ❑ Doubi Check 0 P ua Vacuum Brea tAl
Manufacture: Model: 5 9 e Serial No: 9 2
Date Installedi Lst I pecto�stl Main Line PressureCOPSILocation on Proporty )rSe
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UU LChW-kLCheeks inked at min of 1.0 psi � R.fll,r0.• r-1 d �,.'�. —
a, Device Mechanical Test: Pass '0
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instagatlon: Mesta State/Local Standards Falls Statell-ocal Standards: i;
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Person notstled of any failure: —
Alarm Company/Fire Department Notified:
s 1Lrned off: Datst Time• Turned on: Date: T1me1
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w tM Aast a¢snf Edition of fhe Colorado Crosa•Conrmtlon Control AAanuaL
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e Tested B„1 CerL No. 1 � 7� Expirui Is Phone: - 77�_
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