2011_0310Jul 28 11 03:36p ROBERT MAXALL 972 -692 -8322 p.1
Jul.25.2011 07:36 AM Public Works 9729625199 PAGE. 1/ 1
CHECK ONE
IRRIGATION DOMESTIC FISELIKE
BAcxnm PREVENTION ASSFJI MLY TEST AND MAINTENANCE REPORT
NAND OF PWS: CITY OF COPPELL
PINS T.D. 0
LOCATION OF SERVICE: Z /
The bacl.- low pravmaaa assembly detailed below has been tested and maintained as ragwred by TNRCC
re$t pons tmd is certified to be opemitiag within acceptable pazDa m.
TYPE OF ASSEMBLY
C Reduced Pressure Principle C Presslue Vaciumi Brcal=
0--' Double Check Valve a A=vsphe rc Vaeaum Brczkcr
Maud.=, ��- � Size
Mona, uimba —9 - Located At
Serial Namber t�3 -� O
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER
Double Check Valve Assembly
Ist cbecic o2• U end Cbee3- 0 RM1id Valve Air Inlet Check Valve
Initial Text DC- Clasod Closed right opened at opmed at - Paw
TL& Leaked C1 psid esid
RP- vsid
Leaked p Did not Open 0 Leaked fl
RqL*s
and
Materials
Used
Test A e17�1& C- Closed Closed Tight a Opened at Opened at �_.psld
Rcpsir o vsid
P aid
The above is eerri6ed to be tree.
4,-, .
Firm Add= �.�.�� , � /I /-V,9 GA/• CCM Testa Nc f'�� 7LDOD � r
Z -j %c-
Gauge q F�g S' 7
l=
Post -It' ax Note 7871 °ate 7. 25
Date lest accuracy tested c>
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