Transcription of BACKFLOW PREVENTION ASSEMBLY TEST AND …
{{id}} {{{paragraph}}}
Example: dental hygienist
BACKFLOW PREVENTION ASSEMBLY TEST AND …
San Antonio Water System #00150018 2800 US Hwy 281 N San Antonio, TX 78212-3106 Attention: BACKFLOW PREVENTION Section ASSEMBLY Location / Unit being Protected_____ SUBJECT: Test and Maintenance Report BACKFLOW PREVENTION ASSEMBLY (Circle one) RP DC PVB SPVB RPDA DCDA Please be advised that we have made the following periodic test as required by TCEQ and the San Antonio Water System s Cross Connection Control Program and report the following: Manufacturer and Model of Assembly_____ ASSEMBLY Serial _____Size_____ Service Address_____ BKFL#_____Gauge #_____Gauge Exp Date_____ CHECK #1 CHECK #2 DIFF.
The following form must be completed for each assembly tested. A signed and dated original must be submitted to the public water supplier for recordkeeping purposes*
Loading..
Information
Domain:
Source:
Link to this page:
Please notify us if you found a problem with this document: