The URL can be used to link to this page

2015_0611 (3) C�IECK ONE: IRRIGATION DOMESTIC FIRELINE BACI�'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: i � 3� � j' F' S'r`S- t�e )� r < « �� r TX The bacl�low prevmtion assembly detailod below has beea tested and maintained as required bv TNRCC � regulations and is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY �, Reduced Pmsurc Principle C Pressurc Vacu�Breaker � Double Chcck VaIve � Amiosphere Vacuum Breaker � , {� Maaufactsaer �.1 :�. T (5 Siu ? Model Ivumber � C�!_ LOCatCd At l•v Ll�.�r. K-� �e.r�.'r � � M' ��l? Scrial Nimmber � �{., t� 6 REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUiJM BREAI�R Double Check Valve Assembly lst Check 2nd Cbec1: Relief Valve Air Inlet Checic Valve Inival Test DGClosed Closed Ti�t '4�. ed at Opeaed at esid Ti�t m Leal:ed ❑ � sid _osid R.P-�psid _ �;� o `�� Did not Opm o Leat;ed � �� and Mataials , U� � Test Aft,er DC-Closed Closed Tight o Openod at Ogmed at _�sid Repair Ti�i a �sid __nsid R.P sid The above is certifiod to be true. Firm Name�„�` �'� -h`-�Q L,�...� � i-,;, �, ..� � CCiLlflOd TCSLQ �C'�-, ,., � � L ,�.�...c, ►., r� <. ��,. a-� Firm Address �'��a v � � ^�, �=� �- �> i��^�� •`�ert Tester No. � I� t`'v � 4��ate �� Gauge # _j f> � �..j l. Date last accuracy tested �" � � � � �, White- Customer's Copy Yellow - City Copy Pink-Tester's Copy __ y. � _