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2014_0613 •+ a a tt 3:/ A' - Y :— Wh M:�'eyfL alry Qra ry `Lew.. Vm W mpx - ++.wa_ TruyV' • S FWv .wVRea4N1%v1£+l m M airy.11Kw M(. -t1� ..: Ta. S d. CIIECK ONE. ,/� _ IRRIGATION DOMESTIC >. FIRELINE BACICFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT ,9) NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: /a.J'! S � , % � � < / .-",' =- �- // 72-- %�G /S' GC 4 // / The baclelow prevention assembly detailed below has been tested and mairtrained as required by TNRCC regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY 0 Reduced Pressure Principle ...Mr Pressure Vacuum Breaker 0 Double Check Valve 0 Atmosphere Vacuum Breaker -, Manufacturer / /1/4 Size Model Number FG6 _ / /'/ eV, Located At ld %4f �i <i` -4. t Serial Number ��e:5'S `/ REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Cheek Valve Assembly 1st Check 1 2nd Check Relief Valve Air Inlet Check Valve Initial Test DC- Closed Closed Tight 0 Opened at Opened at c� %vsid / j -/y- Tight 0 Leaked o vsid � � osid RP-______psid � f / Leaked 0 Did not Open o Leaked o Repairs 4-' i`i�i /1�/ 4�/� -- 4 and �- /.-.1 i 71�. d ./,} /...-:, /. ,- 6,,,, -/ j Materials Used Test Altar DC- Closed Closed Tight o Opened at Opgped at / 1 psid Tight D osid // psid SJ RP psid The above is certified to be true. Firm Name lk �, l .... --� �- / 5-�z � �r Certified Tester �f�"i %_f" �� /r � � ."4-c� ,� lr s <<=5,,,, y Firm Address /i ��,. �X i " -%a Cert. Tester No. /- '/ Date e_5 /> " - /l Gauge # %a 6,P Date last accuracy tested � SS- /% White - Customer's Copy Yellow - City Copy Pink - Tester's Copy P.+SAx.» .. msH4:'.s� tN'y'.�y'G Y.eN Ae"lL.... x: YAYN rA- M�CiI^ f .. i..9: &!�v.'e.�". �dWa. G i' a" V. ... X. �.SF- 31K4tflYTYO +iMxywiN,TM49SW �iS=.. - . 34�Y`Ret9M1... CI+M ✓�M1 ^'Catlq • �h :YX A..:.:y6...P` \:...MM�H �.mf04.: X �41.SY'l'.i.ln• \. ... .. .. CIIECK ONE: �/ IRRIGATION DOMESTIC / FIRELINE BACTCFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL (--)--) PWS I.D. if LOCATION OF SERVICE: /lJi'�' S /3�/ l� /�� f °�� // ix .'SG /S G1 ( /U i ��LfG The backflow prevention assembly detailed below has been tested and maint as required by TNRCC regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY c Reduced Pressure Principle �= Pressure Vacuum Breaker e Double Check Valve c Atmosphere Vacuum Breaker Manufacturer e : / c-s/ 7 Size ...7,---- // Model Number ��GG // `r 7 Located At /rim r�/":T /y /ci ,.,, � Serial Number � %es" REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BRF ICER Double Check Valve Assembly 1st Check 1 2nd Cheek Relief Valve Air Inlet Cheek Valve _ __.. Initial Test DC- Closed Closed Tight 0 Opened at Opened at V.-_. paid -/;" /y Tight c Leaked O nsid 2 nsid RP- psid SS Leaked c Did not Open o Leaked O Reps and MateriaLs Used Test After DC- Closed Closed Tight 0 Opened at Opened at nsid Repair Tight o _psid _____psid RP psid . The above is certified to be true. ` Firm Name �h -`6- e - ..0- , �i -". Certified Tester c --- / /!i / c� /S�if=�- 7 „s � �r�fi�/ fl/� Firm Address - // `�:-,i,� 7 J` / S G %G Cert. Tester No. �� /- Date � -,� -/% Gauge # t% /G jO � Date last accuracy tested ,� 5 White - Customer's Copy Yellow - City Copy Pink - Tester's Copy m: . ,... «... Na- 'wq+ €.: aiF , mwe +,,,ro....;..,:, - rosigr�. kfw'» w. rx* isy?hi {WmV" ^ +. .. r.aoncew,a :e. €:v�' ,�.;P......: . +uN:,R.,e�y.. .r.. v...rNR'R4cary ,.�,:,.st �wr ...:k:R+aA F,: t_.;�'we �gN.. n . . .. -. CIIECK ONE: - IRRIGATION DOMESTIC �� PH2E1[I14E BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT / NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: /l>% S /j�7f ./i, > � / 7.5 ��1 ,- /V %_ %SG/i C-e 7 4„4 The baclllow prevention assembly detailed below has been tested and rr+ainr as required by TNRCC regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Principle 1S Pressure Vacuum Breaker C Double Check Valve n Atmosphere Vacuum Breaker Manufacnrer %tii ffr Size � Model Number yl" t /`/ 7 Located At mil 5 /h��.G %.-- Serial Number e` --- ,, e7- ,f --. REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BRF AK:ER Double Check Valve Assembly 1st Check 2nd Cheri: Relief Valve Air Inlet Cheek Valve _. _ - -- - Initial Test DC- Closed Closed Tight n Opened at Opene4, at /, % paid C /, /y Tight C Leaked o ____psid /- 7 psid RP-____psid �Sf Leaked o Did not Open O Leaked O Re-pairs and Materials Used Test After DC- Closed Closed Tight o Opened at Opened at ____psid Repair Tight a _psid _psid RP psid _ _ The above is certified to be true. Firm Nams � �.�ii�i�. / Certified Tester �� /i1' � /lam /sc- 7- f l „fi-. / � �- Firm Address - - i/ �/� %yam � ..73 - ---.4" -- - f - Cert. Tester No. / /3 ?/s Date l /� /� Gauge # G jGS'� 7G> Date last accuracy tested c! 5" White - Customer's Copy Yellow - City Copy Pink - Tester's Copy ,.-.. +m .w am:.,r, va e ..,�„ + q"Ap « .tftn. ,. +.,. :A... Rx.n i� =:P+3+"< �a vev:tt3•aexr'vw::ma.�*vxa.na ^+, alv.isF ,.�„. r*g ��K:rx:,, a,� ,�, a. ��.re- 'C+r��' ,sd n+,.. �lss'. av _ .s •.... CIIECK ONE: IRRIGATION DOMESTIC FIRELINE t y BACK.FLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: /l %9 � � "-//1� ��/ ,4 -cc ��,// i JL- i5C /S � / y 1 T /4f. /,-/--e-, The bacldlow prevention assembly detailed below has been tested and rnairitAined as required by TNRCC regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Principle � Pressure Vacuum Breaker c Double Check Valve n Atmosphere Vacuum Breaker Manufacturer lL� f� Size 9 �//� Model Number m , z /`/ 7 Located At .4.-",--/ r7i�/ /l > / ,-�� , Serial Number 1��r REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BRF 41ECER Double Cheek Valve Assembly 1st Check I 2 nd Check Relief Valve Air Inlet Cheek Valve Initial Test DC- Closed Closed Tight n Opened at Opened at 2 psid � -/,-- /j Tight n Leaked o psid � .0' psid RP-_____psid rS Leaked p Did not Open O Leaked 'J" Reps and Materials Used Test Ages DC- Closed Closed Tight o Opened at Opened at vsid Repair Tight psid _psid RP psid The above is certified to be true. /i j `� / /l /scti Firm Name ....---.-;' -fi. �ri <Yi _-i-.�ior -� Certified Tester � f ter-- r ,-__,,5-,-- �� -y Firm Address , l- �,..• ---� i ›- i ! Cert. Testa No. /�G1 Date � /3 f/ Gauge # G ‹ ✓a 7a ec-% Date last accuracy tested /- 5` -fj White - Customer's Copy Yellow - City Copy Pink - Tester's Copy f`%3,. .......� >., . . ,� ..+� ^:, r1 ,..,w5a:' _c .x� x '�,i*., r'+T5 , . • k*?td`a'& Q�4'!�'SSw+�'MYa.. ko93. P. a.l Slie�i lfiWA?4.2A!. ++=a..n..9... , �!MfFwc!`+!W '= M... +MYIeC. ur«— yp•¢;�.84 w. s,+Y,r z'm.r?H:+ ar .?wbsra. 'a r . < CIIECK ONE: IRRIGATION DO MESTIC -2C- FIRELINE / BACICFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT r ) . NAME OF PWS: CITY OF CORRELL PWS I.D. # LOCATION OF SERVICE: //��5 „/: /92., z r Vie/ ,.//_... .- �� - s i.9 �� T J. ,4 - 1. ,.. The bac Blow prevention assembly detailed below has been tested and rnainrained as required by TNRCC regulations and is certified to be operating within acceptable parameters_ TYPE OF ASSEMBLY C Reduced Pressure Principle ,.1Er Pressure Vacuum Breaker -5 vQ C Double Check Valve C Atmosphere Vacuum Breaker Manufacturer A�J.� fff Size 3// Model Number �� , = , e 7 -1- - /'C 677 Located At / %c, ,.a»��ci Serial Number Gl�� 3 ''� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BRFAICER Double Cheek Valve Assembly 1st Check 2nd Check Relief Valve Air Inlet Check Valve -- - - - Initial Test DC- Closed Closed Tight C Opened at Opened at --'% psid /y -x% Tight o Leaked o psid / psid RP -, psid /ASS L C Did not Open o Leaked C Repairs and Materials Used Test After DC- Closed Closed Tight o Opened at Opened at psid Repair Tight 0 psid psid RP psid The above is certified to be true. / Firm Name ,. �,- �..‘--,.-,-. -/ .. /N �- Certified Tester , i Sr c � 7".-s-- % Firm Address l /` %G Cert. Tester No. �� /''— ' jam75 Date � / /% Gauge # li %G SQ �G, Date last accuracy tested e-- - /j White - Customer's Copy Yellow - City Copy Pink - Testers Copy ;"-"� ,.. .n_ . ,.. 1 `,: ,u± +3.�W'�9M N 'SS:.,. r«,.e.. .,- n:tw..: ,Vm,::svi+RY+a..F'�+. +wbu vaw;,yv:m.Y peg ron?,» r.:.e4.:.,,a.. '^:aursr,:s i v -0. ...A&. _,n... ,msa- .._r._.::,.x`*c s na. a. CIIECK ONE: IRRIGATION DOMESTIC � \ FIRMA/4E BACI FLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: JG %5 5-7 ��cG i �// %�� l 7 A" , �`�•` The backflow prevention assembly detailed below has been tested and tr,ainrained as required by TNRCC regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY e Reduced Pressure Principle Pressure Vacuum Breaker Double Check Valve Atmosphere Vacutmm Breaker Manufacturer /t 7/5 Size Model Number 2't Located At / /`.� `- - Serial Number c4G REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BRA AICER Double Cheek Valve Assembly 1st Check 1 2nd Check Relief Valve Air Inlet Cheek Valve Initial Test DC- Closed Closed Tight 0 Opened at Opened at �/- � psid Tight 0 Leaked o vsid /� nsid SC RP- vsid Leaked p Did not Open o Leaked 0 Repairs and Materials Used Test After DC- Closed Closed Tight o Opened at Opened at nsid Repair Tight o _psid nsid RP psid The above is certified to be true. / f Certified Testes Firm Name . a �-��> /r�� i/� ✓�'� ��- /�7� 5 �iiifi. / Fy i Firm Address l / /i „��., iX %SGiG Celt Tester No. /-/'CG / Date Gauge # Date last accuracy tested White - Customer's Copy Yellow - City Copy Pink - Tester's Copy CHECK ONE: IRRIGATION DOMESTIC FIRELINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT /- .-). NAME OF PWS: CITY OF CORRELL PWS I.D. # LOCATION OF SERVICE: .7e C% - -- .!- • - /fL/h � /10/ � ; ��,. ---- -- C 44 / The bacidlow prevention assembly detailed below has been tasted and maiTirAined as required by TNRCC regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Principle Pressure Vac+n•**+ Breaker S1-' C Double Check Valve c Atmosphere Vacuum Breaker Manufacturer 1t19/ Size �/ Model Number 12 CZ , f� 7" Located At ... ,7 2 -_, - ..--- l`n-< / 1 /r ?�//i�� Serial Number ° G> �� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BRF' Double Check Valve Assembly 1st Check tad Check Relief Valve Air Inlet Check Valve _- Initial Test DC- Closed Closed Tight 0 Opened at Opened at % a psid - /� Tight C Leaked C _psid /• % psid RP-____psid /‘-`. SS i sairti o Did not Open o Leaked C Repairs and Materials Used Test Agar DC- Closed Closed Tight 0 Opened at Opened at nsid Repair Tight cl _____psid _____psid RP psid . The above is certified to be true. Firm Name /f.--,44_ /��yi"vi�iEr/ Ji ,/�-��f Certified Tester �h /.'s /G / /f =L / -CG I- �s r` -. / !"7�• - 1 Firm Address :I/ %.y , /7.3` .SGj CerL Tester No. /3/ D -" /% Gauge # � - /C, G j G - ' Date last accuracy tested Z ---- -5 /% White - Customer's Copy Yellow - City Copy Pink - Tester's Copy n, +m ua. mc� ,hM oA�wb•A U�F�c; " �. xw T�'. 9R- c' sR...rn "a: "v,�q@•t- « -O �1R'ifn%:V"'�+e+'^t°mwx:^'.a .xisu.resaca cessrm- ,.. .,.. "^mod .'+�.+R«�ai�C vri+cErvMan^+ri.., M,. <ra.+...,!'.:. w[ "'brt+Y v .iaiw,xs�vp. ..K .r,:are Tdd, :P"` '4. _._ _ CHECK ONE: IRRIGATION DOMESTIC X FIR-ELINE BACICFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. it LOCATION OF SERVICE: /a', 5":: /��f .4i � /lc% ,./7 f /-- // lX !%rG /i � 7 `j, f, --," The bacidlow prevention assembly detailed below has been tested and maintAined as required by TNRCC regulations wad is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Principle ..-1m" Pressure Vac-uu a Breaker ffr c Double Check Valve c Atmosphere Vacuum Breaker Manufacturer 19.-7 /1/2 Size 3jy, / Model Number 2f .6;- 4 Located At � �_.„ / �� _- /�.Z... ;� Serial Number G}G' 3 � REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Check Valve Assembly 1st Check I 2nd Check. Relief Valve Air Inlet Check Valve Initial Test DC- Closed Closed Tight Q Opened at Opened at `� .7' psid `-/3 7% Tight o Leaked O psid %.: _psid RP-____psid fs Leaked p Did not Open o Leaked 0 Reps and Materials Used Test After DC- Closed Closed Tight 0 Opened at Opened at nsid Repair Tight _psid nsid RP psid The above is certified to be true. Firm Name s /�. �•• . , '.oeii- - �� / i< -�f�� Certified Tester 7/1/- � i � _ 4 .-* /1 6- /3CG ' % fir/_ / . � "_y Firm Address .-- - . % i G / r . Cert. Tester No. f�/ /5=- Date � /� /% Gau # %os0 S�� Date last accuracy tested ` _ 5 -- -/j White - Customer's Copy Yellow - City Copy Pink - Tester's Copy ;; e:ro.- n.'vvmni'AF7mi4..... y.x'+ mzK+::3?a 1, .r rk...:;w✓.vw'..r,.nn W 4 d. 9d ...:Art�"e^.:arb.�W^can�.:.m*R sa+a.s, mM �.- ...... .. r- ate•, «T+:.€..T'e'.'RZ.F' u_..., :N�!?up wl:...i? - :'n.m.*'Al". +,. �� . r ,:....r mm .e ... CHECK ONE: IRRIGATION DOMESTIC / FIRELINE ( BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPF'ELL PWS I.D. # LOCATION OF SERVICE: / //` S r T Iii 3 The backflow prevention assembly detailed below has been tested and Jrmirtrairsed as required by TNRCC regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Principle Pressure Vacuum Breaker 0 Double Check Valve 0 Atmosphere Vacuum Breaker Manufacturer Size " �� Model Number f";= ' e / 7 Located At Serial Number REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BRF'e10ER Double Check Valve Assembly 1st Check l 2nd Cheek Relief Valve Air Inlet Check Valve Initial Test DC- Closed Closed Tight 0 Opened at Opened at paid �./ /y Tight 0 Leaked 0 nsid nsid RP- nsid f S L 0 Did not Open 0 Leaked 0 Reps and Materials Used Test After DC- Closed Closed Tight 0 Opened at Opened at nsid Repair Tight o nsid nsid RP psid The above is certified to be true. Firm Name u�^is / ii� � � i� y %��f Certified Tester ee Firm Address . - 7 / /rte r �%F % ° Cert. Tester No. /-5� /-'�/ S Date Gauge # Date last accuracy tested = 5 White - Customer's Copy Yellow - City Copy Pink - Tester's Copy ♦-M4 n., w y;dv.9 Sn v Ya � �3siw AeJld YA'i %�FbrF. Wt_p6M�Ms SH Sa.,;! tkf�AsY '+zh$,@'- ^.ti &°.L4wGC k: yxd>Y3R^'�YVN1Prw- - •••^' __"'�`rsC. -. Mw.kS:..Egi am tm: ✓ si _ _ .F rw .e ay. n.' ".9d+' , . CHECK ONE: IRRIGATION DOMESTIC x FIRELINE r: BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: ,45" S /9��Ve�ii r �� i� 7,� %' G /,` G/ T *i Xc " k- The bacidlow prevention assembly detailed below has been tested and maintaitled as required by TNRCC regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY e Reduced Pressure Principle „hr.= Pressure Vacutx + Breaker 1 0 Double Check Valve 0 Atmosphere Vacuum Breaker Manufacturer �ii - / Size � - 1 Model Number l� l '''c`4 T Located At ��-/xN � r /r- 7 �c�i; � Serial Number G REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Check Valve Assembly 1st Check 1 2nd Check Relief Valve Air Inlet Check Valve . Initial Test DC- Closed Closed Tight o Opened at Opened a_t nsid e ,'""-/; 7- �/ Tight 0 Leaked 0 _psid � osid f�i / RP-____psid Leaked C Did not Open 0 Leaked _../EK Repairs _ T ; / // /if— �- .�- L // ; 2 � , v and ,.... l 7-7 , / . _. -// Materials �fss i/i Used Test After DC- Closed Closed Tight o Opened at Opened at - 7,'=- S psid air Tight o vsid �.,,P psid fS RP psid The above is certified to be true. / Firm Na . �i��iri- � <.---s Certified Testa c- r �� /S t� f /� , �-/ F�� y Finn Address , % �/i � _. 7> "„)--5--e-,-,..7 Cert. Testa No. f /C Date c5" /� /l Gauge # G %G ��j Date last accuracy tested f r_ -/y White - Customer's Copy Yellow - City Copy Pink - Testers Copy ;,.. ». ... :..?.ate asfn . 4d^ kr^` a' yv .+v?ttCCa�'.2 ue «. <awa'�w„r+ �..ns..+=.....x.?' , .- „....ev ✓ar...,.. -.. .. ,, t;yiayso+¢4flm::a n,. e;?vwe ,a -':-r .. .,n:.e- a.:. m?.m'Y+ , .- m:. r. .... CHECK ONE: y IRRIGATION DOMESTIC FIRELINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF CORRELL 9- PWS I.D. # LOCATION OF SERVICE: /a Pr” ,r The baeldlow prevention assembly detailed below has been tested and mairira*ned as required by TNRCC regulations and is certified to be operating within acceptable parameters_ TYPE OF ASSEMBLY C Reduced Pressure Principle Pressure Vacuum Breaker 0 Double Check Valve 0 Atmosphere Vacuum Breaker Manufacturer A /� 1" Size --- / •� Model Number Located At Serial Number _ - -- — REDUCTD PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Checic Valve Assembly 1st Check 2nd Check Relief Valve Air Inlet Lgh_eck Valve Initial Test DC- Closed Closed Tight 0 Opened at Opened at / -� osid 47 /y Tight 0 Leaked 0 osid Vz � osid /� RP- osid Leaked 0 Did not Open 0 Leaked 0 Repairs and Materials Used Test After DC- Closed Closed Tight 0 Opened at Opened at osid Repair Tight 0 osid nsid RP psid The above is certified to be true. Firm Name < <•� rir.� Certified Tester Firm Address . . /' Cert. Tester No. /3/ �/S Date Gauge # Date last accuracy tested l �% White - Customer's Copy Yellow - City Copy Pink - Testers Copy �.Pa ,t ., " pr^ n- :wr•xenr�Raerf't.^ernsm�TeAr ^:der' :.,::.. ; �a+r•:o®a ,^rte'— � �e #+wsA'ia �e..�,u o�^. n ..;. ,+r ; ,a: +taes�n;am4m°w*, ;p ='„ >. xk .. � .:,�?.. ., CIIECK ONE- IRRIGATION DOMESTIC ,X FIRELINE ��J BACICFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT y NAME OF PWS: CITY OF COPPEL L ��/// PWS I.D. # LOCATION OF SERVICE: /Oi'� S' ei�f� s / J - 1 �j �// T]. %,- /cam' e ,-,: -- --7 `f; 7�l �c- The baclllow prevention assembly detailed below has been tested and rnainraiited as required by TNRCC regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY 0 Reduced Pressure Principle ; Pressure Vacuum Breaker Double Check Valve 0 Atmosphere Vacuum Breaker Manufacturer 7/� i7 Size ��/ Model Number - . Located At fis«/ -f��- � / - - 7 e` Serial Number s' / /S'o REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Cheek Valve Assembly 1st Cheek 1 2nd Cheek Relief Valve Air Inlet Check Valve Initial Test DC- Closed Closed Tight 0 Opened at O�e�ed at - - -- nsid � / , / -/ Tight o Leaked o psid /lam/. - -7".. RP- nsid A-7 �� Leaked p Did not Open o Leaked Or -7:, -4- � .-...- r,� // .- -�� Repairs / / e- / /� / and 7`// 1 Materials �-V ,� -I 7_ Used Test After DC- Closed Closed Tight o Opened at Opened at /, _"--- psid Repair Tight o nsid .• nsid sf RP paid The above is certifie to be true. Firm Name �.� /C� �•. - %: /'�iu s Certified Testa � r �ohris /rte - l��•f�/ .• i Firm Address 1/ ' /��.�� .7 /S °jO Cert. Testa No. �� /� /te Date � / -// Gauge # Oe /O9 .>9,f✓ Date last accuracy tested ,f S' - - /Si White - Customer's Copy Yellow - City Copy Pink - Tester's Copy t n, At,,./^ W. +Y:^'R.".. D %kDt''� ". �Aienip , „,_ J'- 0.W.W1pir,.,.. -, .. .. • _ - ^Aa,v�dfi`rh Rl3iNdttiaC.aF.S .'LNN4IKY� iwV'q ..Ar:A :P.- rM^•VP..G= "ilk. ix�M�lb..N'�R :nniK -.ewo- -.4 CIIECK ONE: IRRIGATION DOMESTIC x FIRELINE BACICFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF CORRELL P - PWS I.D. it LOCATION OF SERVICE: . /r , ��" i •--1 .setrG __ �// .-X ,,,,,, o T ,Gf,1�f , - c - The baclllow 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 C Reduced Pressure Principle � Pressure Vac+n+*++ Breaker . Double Check Valve a Atmosphere Vacuum Breaker Manufacturer AL f/ Size " Model Number �� - rte% 7 - Located At / , �` , - 1 /lzr��s :4- c Serial Number � /oJ • •G REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BR>: AICER Double Cheek Valve Assembly 1st Check 1 2nd Check: Relief Valve Air Inlet [Check Valve Initial Test DC- Closed Closed Tight o Opened at Opened at osid „5"'-/j /% Tight o Leaked o _____psid - - psid ,-/--.,--;,-/- RP- psid L .-�/�n/ Leaked p Did not Open O Leaked -IR” Repairs and /--- ----I-4 1� / / /��/r,- and -4:1- �4/ l� /i/ /./..,:-.-/: r Materials � - „ ,/� 7 5f�is �y Used Test Agar DC- Closed Closed Tight 0 Opened at Opened at / i psid Repair Tight o osid _.„7 / psid ff RP psid The above is certified to be true. Firm Name ,<u.f�... �i�vi��. < %Y�J Certified Tester �fif�s �� r.� « /1. , 5 EX Firm Address ,�.� �i% 7�” r�� Cert. Tester No. eg/ /�� / - Date /� /y Gauge # ,5 /O Date last accuracy tested .4:10 White - Customer's Copy Yellow - City Copy Pink - Tester's Copy pi - _.....,,- v+ exR' r�...+ r. FlY�MV' r3.' wbu!@ M. W. �a^-M T.'. T• T9AMAST::"°. a' MK' YR" , ld"- ugy`STi.9A+cP^'M1V1�p'�...x Y.r. —... .rv_ f. P. ! W... .n, ^ti%R'-0�$�t`S- 4 +N '3' . ✓..'jn.�iA; .NpASaM'. �°° .. �Y .ts3:• Y.. •_c CHECK ONE: V IRRIGATION DOMESTIC FIRELINE l BACKFi.OW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: /Oi .1.: /ice 7.1�� >� /e. 7.3V--- �jm // - �S ®/� �X 7 4 The backflow prevention assembly detailed below has been tested and mninrained as required by TNRCC regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Principle_ Pressure Vacuum Breaker s/!/- C Double Check Valve a Atmosphere Vacuum Breaker Manufacturer /Li. //s Size 2 Model Number L -/ Located At �i ‘:-cX�u- , rJ�z >cni� r Serial Number -- REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Cheek Valve Assembly 1st Cheek 2nd Check Relief Valve Air Inlet Check Valve Initial Test DC- Closed Closed Tight 0 Opened at Opened at .> psid /� -/% Tight 0 Leaked 0 psid psid rr RP-_____psid ,-. z..- G - Leaked 0 Did not Open AC Leaked 0 Repairs ,..7:,- /"-------e.2---.,--- _T S ,; /.:;" ,�i and --15,-- .� /t .,-- l/�/ c Materials .. /Jr,�.,Gy/ ,- 9s5 -/y Used Test After DC- Closed Closed Tight o Opened at Opened psid � P psid Rep Tight 0 psid r; SS RP psid The above is certified to be true. �� Firm Name .� cc �i �i� t- --1 Certified Tester �`is _.��>� /s". _ ■ -..--,...f,.. � Firm Address - r/ /4i7 "�% -;',,j.- , - - Cert. Tester No. ,q7C° /�� /l Data �/% /y Gauge # / jOsQ' >�� Date last accuracy tested ,1" // White - Customer's Copy Yellow - City Copy Pink - Testers Copy CHECK ONE: IRRIGATION DOMESTIC ? FIRELINE BACIC'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT ,91- NAME OF PWS: CITY OF CORRELL, PWS I.D. # LOCATION OF SERVICE: /�� f /`�� liii� � / ,f ` � > .-!/ T�k jrG /S T /-5;-/-/ /- The bacldlow prevention assembly detailed below has been tested and mairir as required by TNRCC regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY 0 Reduced Pressure Principle la Pressure Vacuum Breaker s 7 %3 0 Double Check Valve 0 Atmosphere Vacuum Breaker Manufacturer �� C/r Size Z Model Number / -f -� -/ r i-- 7 Located At / , - �� Serial Number G_3 - REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Cheek Valve Assembly 1st Cheek 2nd Cheek Relief Valve Air Inlet Check Valve Initial Test DC- Closed Closed Tight 0 Opened at Opened at ? %> paid ,<-- / % - /`/ Tight 0 Leaked o _psid psid RP - psid /` Leaked 0 Did not Open --Itz Leaked 0 Repairs err //. - T/z-, ,!f > ,e...7 ,,---t}.--,- and /..../. -,...;/-7-/ � / �� 17 7 Materials ; _{' s �„,../y r , s - Used Test After DC- Closed Closed Tight 0 Opened at at 3% / psid Repair Tight 0 _psid F . - - nsid RP ______psid The above is certified to be true_ / �' / Firm Name A- l o- tee.- ---:;% �%¢ Certified Tester C �` , r �- �!' /TCc r �� ry ` � Firm Address .- l / % /,i y T}- � �,�- 9 Cert. Tester No.,V9CY /�� / Date �/� /% Gauge # ,-%% 0 Date last accuracy tested 6 .-1- 5 —/% White - Customer's Copy Yellow - City Copy Pink - Tester's Copy