2013_1105 (2)CHECK ONE:
IRRIGATION
q
NAME OF PWS:
CITY OF COPPELL
PWS I.D. 4
LOCATION OF SERVICE: R11-
WTIfTaw MZ
Manufacturer size
Model Number ZL2 Located At
Serial Number
An di
REDUCED PRESSURE PRINCIPLE ASSEMBLY
PRESSURE. VACUUM BREAJMR
Double Check Valve Assembly
I st Check
land Check
Relief Valve
Air Inlet
Check Valve
Initial Test
DC-Closed
Closed Tight
Opened at
Opened at
psid
Tight
Leaked
psid
---__psid
fti._L Y/ -psid
Leaked
Did not Open C3
Leaked E3
Repairs
and
Materials
Used
Test After
DC-Closed
Closed Tight
0
Opened at
Opened at
------ psid
Repair
Tight
___-__--psid
____---psid
RP sid
White - Customer's Copy Yellow - City Copy Pink - Tester's Copy