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2012_1214CIIECK ONE: IRRIGATION DOMESTIC FIRELINE BACKFT.OW PREVENTION ASSEMBLY" TEST AND MAII�l'I'ENANC'E REPORT ���7o7i:ily PWS I.D. # CITY OF COPPELL LOCATION OF SERVICE: G / � �� � -e y i"L The baci�low pttveation asscmbly dctailcd below has bem tcstcd and maintained as rcquircd by TNRCC regulations and is catificd to be operating within acreptablc parametcrs. TYPE OF ASSEMBLY C Rcduc. -d Pressure Princiolc C Pressurc Va�-+�+***� Breaker ^3 Doublc Chec1k VLalve o Atmospherc Vajcuum Brcaker Manufacturer �y� / / 5 Size ,! � / Modcl Number � 7 � � Located AL y � U /r � � % �O ��. Scrial Number / � G y 7 3 The above is certified to be true_ Firm Name �C' �iG � � %�/ � � Certified Tester ��, %�� L� % �� s> ,�13 Firm Address /" O /3u k' 7 � 7 el/�? a < >' � � Cent_ Tester No. �� /� ©OD ,'cU1 Data /-� -lc�C �Z Gauge # �' G � t/ / % Date last accuracy tested White - Customer`s Copy Yellow -City Copy Pink - Tester's Copy REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BRF"A�'F'R Double Check Valve Assembly 1st Chekl: 2nd Cheri: Relief Valve Air Inlet Check Valve Initial Tai DC- Closcd Closcd Tight Q Opened at Opened at osid Tight �-/ =� �' Leaked 3 � o osid osid RP- osid I.cakcd p Did noc Open o Lcal:ed � �� � P /.9� �� �, /v ,e and C � � c�� Materials Used Test Alter DC- Closed Closed Tight � Opened at Opened at osid Repair Tight o osid osid RP std The above is certified to be true_ Firm Name �C' �iG � � %�/ � � Certified Tester ��, %�� L� % �� s> ,�13 Firm Address /" O /3u k' 7 � 7 el/�? a < >' � � Cent_ Tester No. �� /� ©OD ,'cU1 Data /-� -lc�C �Z Gauge # �' G � t/ / % Date last accuracy tested White - Customer`s Copy Yellow -City Copy Pink - Tester's Copy