Laserfiche WebLink
AAA Ba kflow Prevention Services ASSEMBLY INFORMATION <br /> i a 4949✓<Yadattr Rd TYPE: SIZE: MFG: <br /> Stockton,CA 95215 h101I)EL; SERIAL u: � ��q ' <br /> Office:877-226.3S69 Fax.209-937-2 ZUR <br /> xlsrWG-4 REFERENCE a: <br /> 4-k.AW 573D Wh ZQ-9-444-7M COM 650-690-6096 13 REPLACEMENT-+OLD SERIAL p; <br /> E-WIG.,GVab"kfksv G0mccut,net fI NEWS PLUMBING PERMIT IV.- <br /> YYrirrPi�n,�yot few* TYPE OFSERVICE, dDOMESTIC C]IRRIGATION ❑FIRE DBYPASS <br /> SERVICE ADDRESS <br /> 9LI SIN E55{NAMES: O 1'�] Opp SITE PHONE; <br /> SITE ADDRE5S-, w �y o CITY! <br /> ASSEMBLY LOCATION., <br /> [FRomew.drnw bIarwaew.raneia-Let lirm,PtoWVLlnftcmirb,arW ramerpomuri*m%w&**{AndrrtrrRil <br /> INTERNAL DEVICE <br /> alrf prpddm Lain wn dma on.Wh m nrrvmp pff nmm wit roam wd fiAw mi+wwr.M gdmnrCa Urokar VgarrW,and 1tpgml <br /> OWNER 1VlANACEMENTADDR SS <br /> 01WNWMANAGWENT: E-MAIL ADDSE55; <br /> MAILING ADDRE55: OFFICE NUMBER: <br /> CITY,STATE&ZIP., fAX NUMQER-, <br /> DOUBLE 0fEC9 VAi VE ASSEM&V TEST RESULTS INFORMATION <br /> REDUCFb PREZURE PffiN 7PLE AS FM8L Y RftF35Ufit VACUUM ERLtAKER <br /> CHECK VALVE CHKK VALVE DIFFERENTIAL AIR INLET VALVE CHECK VALVE <br /> NO.1 NO.Z RELIEF VALVE <br /> imYOAL HELb AT: HELD AT; OPENED AT; OPENED AT' HELD AT; <br /> ><Est Pstn MID Ps,o m0 psin <br /> LEAKED IJ CLOSED TIG11T(RP) OPEN UNDERZ.aPSIE) OPENED UNDER],0FSID0 LEAKED ❑ <br /> LIED ❑ DID NOT OPEN C DID NOT OPEN ❑ <br /> 1) ❑CLEANED 1) ❑CLEANED 1) ❑CLEANED > ❑GLEANED 11 ❑CLEAR.EM <br /> TI REPLACED: REPLACED: REPI.AiC#-q: REPLAOW, REPLACED: <br /> E Z) ❑NSC 2} n Di$C 2) n 01SCIS) 21 n DISC 2} m DISC <br /> P S) n$PRING ;} n$MINr5 9) ❑SPRIHC# SI Cl DIAPHRAGM 3) nMODULE <br /> A 4) COMM A) UGVIDE 4) ❑DIAPHR,4GMIS} 4) ❑FLOAT 4; ❑OTHER; _. <br /> 1 5) ❑SEAT 5) 115EAT 5) 171SEAT(5) S) r10THER; <br /> R 6) ❑MODULE 5) ❑MODULE 6} 130-RINGts) <br /> 1) ❑G-RINGIS) 7) ❑0-ROIG{S) 7) ❑MODULE <br /> ❑OTHER,: 8 GOTHER: II ❑onim <br /> 7E3T <br /> TESTi HUD AT; HELD AT: OPENED AT! Opt NfI]An HELaAT. <br /> AFT <br /> REPApt P50 P#aD McD POD <br /> {LO$EDTICyh#T RP u PS1C <br /> INITIAL TEST TESTED AFTER RE PAIS YES "D <br /> STAfLT 71rNE: START TIME;— <br /> vROPERINSTAUA-WN K COMMENTS: <br /> R.V EXERCISED � r <br /> ENG 7rMF: qq mD nAAE BEFORE TEST <br /> DA Ci DATE: S.d.V CLOSED[ <br /> p� ON af,RRA+AL � <br /> PASSED& FAILED 0 PASSED 0 F1 ILlED 0 <br /> SERVICE RESTORED X ` <br /> TAG M1 TAG ale —..._-.. ... } r <br /> IA <br /> MEMWADING: MET RREADIMG; UNEPRE55URE� <br /> IN I FIAL TE STER TESTE R AFTER REPAIR <br /> TE 111MME. Jordan Lee TESTER NAMI-- <br /> CER71FICATION N: 16194 CERTIFICATIDN M. <br /> TEST in saw#t. 04 15 1440 7M XIT SERIALS- CUSTOMER NAME: _ <br /> CALIBRATION DAIT.E 1 10 2025 CAUBPA110MDATE; <br /> 11d4T fI�' SIGNATURE: CUSTOMER SIGNATURE: <br />