2013_0606_RPZ (3)CHECK ONE:
IRRIGATION DOMESTIC_� FIRELINE _F-7
BACKFLOW PREVENTION ASSEMBLY TEST AND XQN TENANCE REPORT
NAME OF PWS: CITY OF COPPELL
PWS I.D. #
LOCATION OF SERVICE: US Postal Service, 951 W. Bethel Road
The back-flow prevention assembly detailed below has been tested and maintained as required by TNRCC
regulations and is certified to be operating within acceptable parameters. _
TYPE OF ASSEMBLY
❑✓ Reduced Pressure Principle C Pressure Vacuum Breaker L
❑ Double Check Valve ❑ Atmosphere Vacuum Breaker�i
Manufacturer Watts __ _ -. Size 3/411 /
Model Number 009 Located At small cooling tower
Serial Number 59725
The above is certified to be true.
Firm Name Professional Backflow
Firm Address 5068 Avery, The Colony
Gauge # 372461
Date last accuracy tested 03/03/13
Certified Testa Scott Masdon
Cent. Tester No. 2524 ate 06/06/13
White - Customer's Copy Yellow - City Copy Pink - Tester's Copy
REDUCED PRESSURE PRINCIPLE ASSEMBLY
PRESSURE VACUUM BREAKER
Double Check Valve Assembly
1st Check
2nd Check
Relief Valve
Air Inlet
Check Valve
Initial Test
DC- Closed
Closed Tight ❑
Opened at
Opened at
nsid
-�
Ti
_ caked 9`
2.2 t?sid
-----psid d
RP.8 sid
Leaked
2.6
Did not Open ❑
Leaked ❑
Repairs
and
Materials
Used
Test After
DC- Closed
Closed Tight ❑
Opened at
Opened at
osid
Repair
Tight ❑
sid
nsid
RP sid
The above is certified to be true.
Firm Name Professional Backflow
Firm Address 5068 Avery, The Colony
Gauge # 372461
Date last accuracy tested 03/03/13
Certified Testa Scott Masdon
Cent. Tester No. 2524 ate 06/06/13
White - Customer's Copy Yellow - City Copy Pink - Tester's Copy