2012_1130 (2)CIILCI� ONE
IR.RIG.ATION�.n�_ DOMESTIC � FIRELINE
BACI�Z.OW PREVENTION ASSEMBLY 'PEST AND MAINTENANCE REPORT
NAME OF PWS: _�! ?_�� �' � .[c ^���r - /.t
PWS Y_D. #
LOCATION OF SERVICE: 600 Freeport /Duke - Freeport IX
The backflow prevention asscrnbly detailed below' has been tested and. maintained as required by TCEQ
regulations and. is certified to be operating within acceptable parameters_
TYPE OF LY
Reduced Pressure Priacinle Pressure Vactttmrs Breaker
e✓ Double Check Valve Atmosphere Vacuum Breaker
Manufacturer Watts. Size 3/4'•
Modell�iumber 007M1
Scial Number 48777
Located AZ
NW corner of building in vault
The above as testified to be irtxc.
Fizm Name Action Fire Pros
Firm Address PO Box 797 Waxahachie
Gauge # 07090476
llate Iasi accuracy tested 9 -21 -12
iCTM S>FtFAKFR
Check Valve
nsid
Leaked Q
nsid �
- -�I
Certified Testa Allen Stevens �'� /�.�-
C� �..�a No BP0009860 Dam 1 1 -30 -12
White - Customer *s Copy Yellow -City Copy Pink - Tester's Copy
--
REDUCED PRESSURE. PRINCIPLE A.SSEIVIBLY
PRESSURE VACi
Double Check Valve Assembly
1st Check
2nd Chec3:
Relief Valve
?sir inlet
�tial Test
DC- Closed
Closed Tight
Qpcacd at
Opened at
!�
�S /'
Tighter �
RP- DSI
Le�;ed
Leaked
� ' �
psid
nsid
Did not Opm o
Repairs
and
Matcriais
used
Test Afars
DC- Closed
Closed Tight t7
Opened at
Opcnod at
Repair
Tight Ct
nsid
asid
RP sad
The above as testified to be irtxc.
Fizm Name Action Fire Pros
Firm Address PO Box 797 Waxahachie
Gauge # 07090476
llate Iasi accuracy tested 9 -21 -12
iCTM S>FtFAKFR
Check Valve
nsid
Leaked Q
nsid �
- -�I
Certified Testa Allen Stevens �'� /�.�-
C� �..�a No BP0009860 Dam 1 1 -30 -12
White - Customer *s Copy Yellow -City Copy Pink - Tester's Copy