2014_0603 (8) CHECK ONE:
IRRIGATION DOMESTIC I I PIRELINE I ✓
K
BACP FLOW PREVENTION ASSEMBLY TEST AND IVIAINSENANCE REPORT
NAME OF Pws: CITY OF COPPEI.L
PWS I.D. it
LOCATION OF SERVICE: US Postal Service, 951 W. Bethel Road
The bacldlow preventioa 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
0 Reduced Pressure Principle 0 Pressure Vacuum Breaker
CI Double Check Valve o Atmosphere Vacuum Breaker
Maaufacaaer ersey Size `l
Model Number DC Located At Riser # 5
Serial Number 8019824
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER
ER
Double Check Valve Asse ably
1st Check tad Check Relief Valve Air Inlet Cheek Valve
Initial Test DC- Closed Closed Tight Opened at Opened at paid
Tight,-..., Leaked Q nsid nsid
RP- rI -sid
Leaked 0 3 0 Did not Open O Leaked rJ'
Repairs
and
Materials
Used
Test After DC- Closed Closed Tight o Opened at Opened at esid
Repair Tight 0 psid nsid
RP nsid
The above is certified to be true.
Firm Name Professional Backflow Certified Zero Scott Masdon
Firm Address 5068 Avery, The Colony Cert. Tats No. 2524 Date 06/03/14
Gauge # 002013
Date last accuracy tested 03/03/14
White - Customer's Copy Yellow - City Copy Pink - Tester's Copy