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2014_0714_RPZ� ' C�IECK ONE: IRRIGATION DOMESTIC FIRELINE � � ' BACI�LOW PREVENTION ASSEMBLY TES?AND MAINTENANCE REPORT � tl '�iAM'E OF PWS: 'f CITY.pF COPP�LL �� . . , � � �,` P1�VS I.D:# ' " j ' � . LOCATTON OF SERVICE: �� � �1� ��• f,� L,(1 a� The bacl�low preveation assembly detailed below lms beea tested aad maintain� � nq�d bv TNRCC regulanons aad is certified to be operating within ac.ceptable paramcters. TYPE OF ASSEMBLY � Raiuced Pressure Principle ❑ Pressurc Vacu�Breaker __._ .,__ _�. _�., __�e..__,..,� Dauble.Check��alvc . . _....�.v.�.:�_�_:�o _ _. _Amiosphere Vacu�tn Bnaker__= -_ �'' . _. � - . _. _,. _,__- 1 ,� Maaufacuaer �!� �-3 Siu � Modei Number !U 9 /�7 �1� �' � Locaud At � � �� � �� ,` Scrial Nimmber ?/ ,z � /_`- REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSiJRE VACUUM BREAI�R ` � Doubk Cbeck v alve Assembly ; °- `; - a _ �:; , ist C3cck _ 2nd Chtcl� .p: 8. �telief�alve Air Inlet �tiecic Va�ve : ` � Ininal Test DC-Closed Closed Ti�t Opeaed at Opened at �nsid �` Tight ef Leal:ed o 4�' 7 psid _osid �� s S RP-9° �sid Leai;ed o Did aot Opea o Leal;ed o RePairs and Mataials 'tJsed , : ! -- �� , _ .�. _ _ , � :. , . . _ . _ - ,- � , � j- .v_.� �.. _�., � Test After DC-Closed Closed Tight o ppened at ppeaed at __nsid Repair Tight o Dsid �osid RP sid The above is certifiod to be true. , Firm Name �`/�,�,�r�, �k,�k �r.- Catified Tester �°'��,:f,� i�T�` , ._.�._ . �. . , � .. �- : . �'�r f r' �, / �:D� 7-�,��/y ' Fum Addres� l�,a� �- ` ; ���' Cat Testc No. QG° Y�/!>G' � � . . `��s�� r / �� ,.,.� z � ,, _< � �� Gauge # D 7/� � i U llate last accuracy tested �" `/�' �'�'/f White- Customer's Copy Yellow - City Copy Pink-Tester's Copy