2014_0701 CIIECK ONE:
IRRIGATION x DOMESTIC FIRELINE
BACICFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT :(9).
NAME OF PWS: CITY OF COPPELL
PWS I.D. #
LOCATION OF SERVICE: ,,2/.2 EpP!'9 fa 1paa 1,7 _
The baeldlow prevention assembly detailed below has been tested and maintained as required by TNRCC
ra and is certified to be operating within acceptable parameters.
TYPE OF ASSEMBLY
C Reduced Pressure Principle C Pressure Vacuum Breaker
Doubl heck Valve C AtmosrhR Vac yn Breaker
Manufacturer � �� Size /Y
Model Number J � Located At f
Serial Number L ' ..- .z6C\ 3
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BRF AICER
Double Checic Valve Assembly
1st Cheek 1 2nd Check Relief Valve Air Inlet Check Valve
Initial Test DC- Closed Closed Tight Opened at Opened at osid
Tight Leaked C psid psid
RP- osid
Leaked C � ` ' Did not Open 0 Leaked C
R
and
Materials
Used
Test After DC- Closed Closed Tight o Opened at Opened at osid
Repair Tight C nsid osid
RP paid
— ' - — --
The above is certified to be true.
Firm Name Ol Accuracy Bacictlow Certified Testa ric I/QS f
Firm Address
Frisco, TX 75035 Cent Testa No1 / 1 ,5 - 73 Date — 7 - 1 -� IA
r i ao
Gauge # Q / / )i q /
Date last accuracy tested —6 —)y
White - Customer's Copy Yellow - City Copy Pink - Tester's Copy