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2015_0626_PVB �y C�IECK ONE: IRRIGATION DOMESTIC FIRELINS BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT rraME OF pws: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: I�� S S- ��-�� 1�a`0� �` � The bacl�low prevmtion assembly detailed below has beea tested and maintain� � nq�� bv TNRCC regularions aad is certified to be operating within acctptable paramcters. TYPE OF ASSEMBLY e Reduced Pressure Principlc '�: Pressure Vacu�Break,er ❑ Double Chcck Valve o Am�osphere Vacuum Breaker rr Manufactsaer i�� Siu � Model Number�Oc� M�-} Q'� Located At Vi1a5�,��, ►�Vl �.; .,,�C Serial Nimmber ��7�`��, REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double CLeck Va1ve Assembly lst Check 2nd Checi► Relief Valve Air ldet Check Va1ve Inival Test DGClosed Closed Ti�ht ❑ Opened at Opened at •��sid Ti�t o Leal:ed o �sid �',D psid �/��//S RP-_psid �;� p Did not Opea O Leal:ed � Repairs and Materials Used Test After DC-Closed Clos�d Tight o Opeaed at Opeaed at �sid Repair Tight o �sid osid RP sid The above is certifiod to be true. Firm Name L0`�{viu t�cr�r�e�'t,�, t Cestifiod Testa �� ►"cx.1L I sa� S. c.��,�� e��,,y �� Firm Address �'�-=� I'�'' Cert.Tessta Na .3 .��a I Date (�auge # ��(��3� llate last accuracy tested 3 J White - Customer's Copy Yellow - City Copy Pink-Tester's Copy �� C�IECK ONE: IRRIGATION DOMESTIC � FIRELINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAIIV'I'ENANCE REPOR? NAN�OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: I�� S - ��2.�� ,r 6'�'�- w� " The bacl�low prevmtion asscmbly detailed below has beea tested and maiatained as required by TNRCC reguladons and is certified to be operating withia acceptable parameters. TYPE OF ASSEMBLY e Reduced Pressure Principle �C Pressurc Vacu�Breaker � Double Chxk Valvc o Atmosphere Vacuum Breaker v� �� s� � �� Maaufact�aer �� Model N�ber �� Located At ln��S►,,�''� ✓�ch;r.r-e.S Scrial Nimmber �� 7� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUiJM BREAI�R Double Check Valve Ass�bly ist Check 2nd Checi: Relief Valve Air ldet Check Valve Ininal Test DGClosed Closod Tighc o Opened at ed at �.�___Fs�d Tight o Leal:ed o �sid ��_psid �,J��J� �__.�S�a I,�;� ❑ Did not Opea o Leal:ed � �P� and Materials Usod Test After DC-Closed Closed Tight o Opened at Opea�at __nsid Repair Tighi o osid osid R.P sid 'I�e above is certified to be true. Firm Name��'�`� C`�""''�°��' � Certified Testa R ob�-�— 3 r o�L. s. CP�+S►,.�i ¢�1 � 3ov Fi m Address f�'��.��N-�� Cat Tester No. � °O� 3q°� Date_ (�suge � (7� 1�?,03 v� llate last accuracy tested � I� ) � White- Customer's Copy Yellow - City Copy Pink-Tester's Copy � C�iECK ONE: IRRIGATION DOMESTIC � FIRELINE BACIC�3rOW PREVENTION ASSEMBLY TEST AND MAIIV'I'ENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: (��s S • ��I-� <<�"��'- �� ' The bacl�low prevmtion asscmbly detailod below haz bxa tested aad maintained as required by TNRCC regulations and is cerdfied to be operating within acceptable paramettrs. TYPE OF ASSEMBLY e Reduced Pressure Principle � Pressur�Vacu�mm Breaker � Double Check Valve o Amnosphere Vacuum Breaker Manufact�aer �� Siu � �• Mode1 Number 1�0� ►M►�- QT Located At �'`�`^7�^:"'`� W``�."�y�� scrial Nimmber �P7 y�O�$ REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACULTM BREAI�R Doubie Cbeck v alve Ass�bly lst Check 2nd Checl: Relief Valve Air ldet Check Valve Ininal Test DGClosed Closod Tight � Opeaed at O,pened at �3 ° psid Ti�t o Leal:ed o Dsid o�sid �p/�(o/iS R.P-_,,,psid �;� p Did not Opea 0 Leal:ed � �P� and Mataials Usod Test Aftet DC•Closed Closed Tight o Opened at Opeaod at __�sid Rcpair Tight o vsid __osid R.P sid The above is certified w be true. Firm Name��.�1 C o�^��e1-��°� 1 Catifiod Testa ,`��- �-lUc-IL rs«� s- �.e,,,��,� �e�� ' � �N3q� F�p�s �►n_�:..�e„ T�- Cat Teste No. Date_ Gauge # Q�ia3o3c� Date iast accuracy tested 3 � 3 15 White- Customer's Copy Yellow - City Copy Pink-Tester's Copy �� C�IECK ONE: IRRIGATION DOMESTIC � FIRELINS BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: I�7� S• �� ►^'�. �. The bacl�low preveation asscmbly detailed below has beea tested and maintained as requirad by TNRCC reguladons aad is cectified to be operating within acceptable parameters. TYPE OF ASSEMBLY e Reduced Pressure Principle � Pressure Vacu�Breaker � Double Chcck Valve o Atmosphere Vacuum Breaker Maaufactsaer 'in�cr�� Siu � ►, Modei Iv�ber �� V�'�'� �'� Locaud At V�1�5 r^�^� r��.,c,ha�e-S Scrial N�ber �7�SS � REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check v alv�Ass�bly lst Cherk 2nd Checi: Relief Valve Air ldet Check Valve Iainal Test DC-Closed Closed Tight 0 Opeaed at O�ened at a'y nsid Ti�t o Leal:ed o �sid ��sid /�,.co//� R.P-_psid �;� p Did not Opea o L,eaiced � �P� and Mataials Usod Test Atter DC•Closed Closed Tight o Opeaed at Opmod at �sid Repair Tight � osid osid R.P sid The above is certifiod to be true. FirmName ��,�k,,.� ��,r�+►•erc,°� ► CeRifiedTester ' -"`�'"` ��"`� i��, s. ��.N�.� �,�,�;r �� Firm Address i�''�=�t T'�- Cat Tester Na �d`�� Date (�auge # (731 ��o�v Date last accuracy tested � �3 /S White - Customer's Copy Yellow - City Copy Pink-Tester's Copy �� C�IECK �NE: IRRIGATION DOMESTIC )C FIRELINS BACI�'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAN�OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE: I�7S J. �-e.�-a- I l NC, �� The bacl�low preveation assembly detailed below has beea tested aad ma�nta�n� � nq� �y TNRCC reguladons aad is cenified to bc operating witbin acceptablc paramcters. TYPE OF ASSEMBLY � Reduced Pressuiree Principle � Pressure Vacu�Breaker ^ Doublc Chcck VaIve o Atmosphere Vacuum Breaker Maaufact�er ��5 Siu % �� Modei N�ber L�c�o$ �L � Locaud At �h�+� �.�1��1� '� C`�'�-e�S Scrial N�ber �3a57 REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Doubie Check v alve Assembly lst Check 2nd Checl: Re[ief Valve Air Inlet Check V�Ive Ininal Test DC-Closed Closed Tight o Opeaed at Opeaed at .�,�_psid �/a�ll� Tl� ❑ Leal.ed o __nsid _.osid R.P-_psid �;� p Did not Opea o Leal:ed � �� and Mataials Used Test After DC-Closed Closed Tight o Opeae�at Opcnod at �sid Repair Tight o �sid nsid RP sid The above is certified to be true. Firm Name L�� c��v�;�,► cQasoa r«� �b-�s�r �f«.�. �svo S- c e,.,�„ �e�� ..,�.yy*t-3� Firm Address M�K,rN�y �i Cat Testc No. � Date_ Gauge # �31a3o^3� llate last accuracy tested I� /� White - Customer's Copy Yellow - City Copy Pink-Tester's Copy ��D C�iECK ONE: IRRIGATION DOMESTIC FIRELINE BACI�'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAN�OF PWS: CITY OF COPPELL PWS I.D. # LOCATIOIv'OF SERVICE: Iv�� 5 - �� I r`�� ,. The baci�]ow prevmtion assembly detailed below has beea tested aad maintaiaed as required by TNRCC regvlauons aad is cerdfied to be operating within acceptable parametcrs. TYPE OF ASSEMHLY e Reduced Pressure Principle �' Pressure Vacuimm Breaker � Double Check Valve o Atmosphere Vacuum Breaker Maaufactsaer ��5 Siu 3�'�ir" Modei Number �-f�Od?j �C, Q� Located At ol�¢, v""=,�1�� f oai-er5 Serial Ni�ber �Aa-3� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACWM BREAKER Double Check Va1ve Ass�bly lst Check 2nd Checi: Relief Valve Air ldet Checic Valve Ininal Test DC-Closed Closed Ti,,P.ht ❑ Opeaed at Opeaed at �sid Tight ❑ Leal:ed ❑ �sid osid ��(,�/S R.P-_psid � p Did not Opea o L,eal:ed � �� and Mataials Usod Test After DC•Closed Closed Tight o Openod at Opcaad at �sid Repair Tight o �sid esid R.P sid The above is certified to be we. Firm Name �-�,^,�o,"' faM,Merr�'G\ Cettified Tata 1�� '�`�� 15�a 5. �e�u\ �X,P� 3oc' Firm Addr�ess N��=� � Cert Testa No. 3='��Date_ c�auge # �1�3��U � Date last accuracy tested 3 �� f� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy � 11 C�IECK ONE: ` � Y IR.RIGATION DOMESTIC �� FIRELINE BACI�LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: ID 7S S • �-Q�� I i�N2 �� The bacldlow przvmtion assembly detailed below has beea tested aad maintain� � nq�� by TNRCC re¢ulations aad is cerdfied to be operating within accaptable paramcters. TYPE OF ASSEMBLY e Reduced Pressure Principle � Pressure Vacui�Breaker ❑ Double Check Valve o Amiosphere Vacuum Breaker 5 Siu / �� Maaufact�er �n1'�}� � � Model Number ��a°$ ��- Q� Located At 0I bu�C vJc,l{c :r� Cv�1-e�S Serial Nimmber O��3 7 REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Check Valve Assembly lst Check 2nd Check Relief Valve Air Inlet Check Valve Initial Test DGClosed Closed Tight ❑ Opeaed at Opeaed at 3 '� osid Tight ❑ Lealced � nsid ___osid �la�/�s �-_ps�a �;� o Dia noc Opea o Leal;ed � �P� and Materials Used Test ARet DC-Closed Closed Tight o Opeaed at Opea�at nsid Repair Tight o �sid osid RP sid The above is certified to be true. Firm Na�e �-"w�",.� lc�r��l CertiSiod Testa f� � ��'� � rS� S- �e,,,�-�.� �,,..�y tr3on girm pddr� y"t= Cert Te�No. o a� 3 9 Date_ Gauge # 1��I a 3�3C� llate last accuracy tested Z/ � 3 �� White - Customer's Copy Yellow - City Copy Pink-Tester's Copy �1�- C�IECK ONE: IRRIGATION DOMESTIC FIRELINS BACI4'i.OW Pi�VENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAIv�OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: I��S S. �'J-�.��- � i r�2. �..�- The bacl�low preveation asscmbly detailed below has bxa tested and maintain� � nq�� bv TNRCC re_eulations aad is certified to be operating within acceptable param�ters. TYPE OF ASSEMBLY C Reduxd Pressure Principle � Pressurc Vacui�Breaker � Double Check Valve ❑ Am�osphere Vacuum Breaker Maaufacturer 1�.��t��5 Siu ��L� �, Model Ivumber ��o �M.`� � Located At �t'�o�e, i�lu.l I�i�► l�o�.�r S s«;al N�ber ��°33� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Doubie Check v alve Assembly lst Check 2nd Cbecl: Relief Valve Air Inlet Check Valve Initial Test DC-Closed Closed Tight ❑ Opened at Opeaed at �d Ti�t o Leal:ed o __,osid 1 2 psid (��(��S RP-_,�sid 7 �;� ❑ Did not Opea o L,eal►ed � �� aad Mataials Used Test ARer DC-Closed Closed Tight o Opeaed at Opeaod at _,..flsid Repair Tight 0 �sid nsid RP sid The above is catified to be true. Firm Name Lc�� C c�n�-crC�K 1 Certi£ied TGster 1��" �i'o`fL I�cx1 S. C,a,.,�-r�,� �2xury ��c� Firm Address ✓"`c_� _ Cert.Testc No. � oo\'-) y"` Date_ Gauge � ��Jl�3v3� llate last accuracy tested 3 � 3 � 5 White- Customer's Copy Yellow - City Copy Pink-Tester's Copy �� C�IECK ONE: IRRIGATION DOMESTIC FIRELINE� BACT�LOW Pf�VENTION ASSEMBLY TES?AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE: I(�7� �• �-Q-�} �'^'�- � The bacl�low preventioa asscmbly deLailod below has beea tesi�ed aad ma;nt�ed as required by TNRCC regulations and is certified to be operating within acr.tptable paramcters. TYPE OF ASSEMBLY e Reduced Pressure Principle �jC Pressure Vacuimm Breaker D Double Check Valve o Amiosphere Vacuum Breaker Manufactsaer in��•� Siu �/-��• Model Number �� O�� r L- aT Locaud At t�tho��. c,J�Nz;� C�1 erS Serial Nimmber ��310 REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACULJM BREAI�R Double Cbeck Valve Assembly lst Check 2ad Checi: Relief Valve Air ldet Check Vaive Inival Test DGClosed Closed Tight o Opened at Opened at °1_._Ps�d Ti�i ❑ Leaked 0 _�sid _osid (o��/�5 RP-�psid L,�;� ❑ D i d no t O p e a o L e a l:e d � �P� aad Mataials Used Test Aftet DC-Closed Clos�d Tight o Opeaod at Opeaed at �sid Repair Ti�t o Dsid __�osid RP sid The above is catified to be true. Firm Name I�l�� fov��.�r�,�a I Catifiod Tester �� 3''�'�f� �� S. L-�"`'�'r`1 t��y � "� ubl�{ Firm Addrresss ��_�{ � Cert. Tater No. �3"►�Date_ (3auge # �3!�30�p Date last accuracy tested � �� White - Customer's Copy Yellow - City Copy Pink-Tester's Copy �� C�IECK ONE: IRRIGATION DOMESTIC 1� FIRELINE BACI�'I.OW P�,VENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE: �(�7� 5� I�a�,�-�- I ��. �� The bacl�low preveatioa assembly detailod below has bxn testod aad maintained as required by TNRCC reguladons and is ctc�tified to be operating within acceptable paramcters. TYPE OF ASSEMHLY C Reduced Pressure Principle � Pressure Vacuimm Breaker � Double Check Valve o Atmosphere Vacuum Breaker Maaufacuaer �`'"��5 Siu �/� �� Model Iv�ber D� �� T Located At A bcx��- v�k��IL�`� C v�t.e�S Serial Nimmber 3�( 'r�� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Doubie C3eck Valve Assembly lst Check 2nd Checl: Relief Valve Air ldet Check Valve Ininal Test DC-Closed Closed Tight o Opeaed at at -�sid ) Ti�t ❑ Leal:ed o �sid •� sid (p,��/ RP- �sid ( �� p Did not Opea o Leai:ed o �P� and Materials Used Test After DC-Closed Closed Tight o Opeaed at Opeaod at __�sid Repair Tight ❑ osid osid RP 'd The above is catified to be true. FirmName��`^�'�`�'' Cc�rnr�wL��.) CatifiedTesta r�'�`'-°r,i-- �3"'o"�tL I�ou . C 2,-N�+z.\ �2�-li r�/ '� FirmAddress �"'�c.�.`:��,� T,� Cert TesterNa �� Date cauge � (�3�� 3�"3c� Date last accuracy testea 3 �3/� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy �1� C�iECK ONE: IRRIGATION DOMESTIC FIKELINE BACI�'I.OW P�.VENTION ASSEMBLY TES?AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: �� s• � �k � ��"� �- The bacl�low prevmtion assembly detailod below has beea tested aad maintained as requirod by TNRCC reguladons aad is cerdfied to be operatiag withia acceptablc paramcters. TYPE OF ASSEMBLY e Reduced Pressure Principle ?� Pressure Vacu�Breaker � Doubk Check Valve o Amaosphere Vacuum Breaker Maaufact3aer \,�r,�� Siu 3��, Modeilvumber �I� bo� QL C�2�" LocatedAt �1�uf, "�J�11C- �`�+ Co�l-ers s«1�x�� O� �38 REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUIJM BREAI�R Double Check Valve Assembly lst Cherk 2nd Checl: Relief Valve Air ldet Check Valve Iniaal Test DC-Closed Closed Tight ❑ Optaed at Opeaed at �._psid Ti o Leal:ed o _nsid osid Cp�a�//� �sid �;� p Did not Open O L� � �P� and Mata�ials Usod Test Aftet DC-Closed Closed Tight o Opeaed at Opeaad at __Dsid Repair Tight o �sid _,flsid RP sid The above is catifiod to be true. Firm Na�e �L•�"'�� ,^"'"`��'�`�� Catifiod Testa �� 13i`"'��' 'SJ G �j. C.a.�a..�—� 'Q'i.�w y *t"�ic� Firm Address f��r,""'`W �.-- Cat Testc No. �°�'1`I 3 y�1 Date_ (�auge # ��)a 3 v�c� Date ]ast accuracy tested 3 /3 / 5� White - Customer's Copy Yellow - City Copy Pink-Tester's Copy �1(� C�IECK ONE: IRRIGATION DOMESTIC FIRELINE BACKFZOW P�.VENTION ASSEMBLY TEST AND MAINTENANCE REPORT' NAI�OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: I�7 S 5 • �\� i;�v e. �, Tbe bacl�low p�evention assembly de[ailed below h�s bem tesi�ed aad main ain� � nq�� by ZNRCC regulauons aad is certified to be operating withia acceptable paramottts. TYPE OF ASSEMBLY � Raiuced Pressurc Principle e Pressurc Vacuimi Brealcer � Double Check Valve o Amzosphere Vacuum Breaker Maaufacuaer W��S s� �a�� Modeilvumber C7C%9 Q"''� LocatedAt ��- �'�a�< „� �c,o1� serial N�ber � `� �a�'3 / REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�CUUM BREAI�R Double Check Valve Assembly lst Check Znd Checl: Relief Valve Air Inlet Check Valve Inival Test DC-Closed Closed Tight ❑ Opened at Opened at nsid Ti�t ❑ Leal:ed ,� �_.psid _�sid �pl�(��1 t RP-_,psid �;� � Did not Open O Leal:ed � �� Wc+��'S � oo�l �-� �,:�t- Materials �'a' Usod Test After DC-Closed Closed Ti�t � ed at Opeaod at �sid Repair Tighi 1�- � -��psid _�sid RP � sid � The above is catified to be true. Firm Na�e LA�-�"^� C"�•�^'''`-�'�'1 Certifiod Tessca I�ob�+ ��"►c_- I 5 vo 5. c��.,o.� -�'c,c,p�y �� Firm Address �-��.^.� �� Cert.Tastc No. �'�y3�`� Date Gauge � D�, 1��i ��o Date last accuracy tested 3 / 3 / �— White- Customer's Copy Yellow - City Copy Pink-Tester's Copy �c7 C�IECK ONE: LRRIGATION DOMESTIC ` FIRELINB BACI�'LOW Pf�.VENT'ION ASSEMBLY T'ES?AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE: I��S S - ��" `' ^'�- R�� The bacl�low prcveation assembly detailed below has beea tested aad maintained as required by TNRCC n�ulations aad is certified to be operating withia acceptable paramctcs. TYPE OF ASSEMBLY ;�' Reduced Pressure Principle e Pressure Vacu�Breaker � Doublc Check Valve ❑ Atmosphere Vacuum Breaker Maaufacuaer 1/�'/'��S Siu �� , Modei Nimmber � �� Locaud At a.\�`'` `^�uf�,�'�,,�a�i�S Serial N�ber R`�s�^77 REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACWM BREAI�R Double Check Valve Assembiy lst Check 2nd Checl: Relief Valve Air ldet Check Valve Inical Test DC-Closed Closed Ti,Pht � at Opeaed at flsid Ti�t ❑ Leal:ed �f! C�psid osid ��L/i j �sid � � Did not Opea O L,eal:ed � and� �c� as� �T � Materials ,��,:�� `�,'� Used Test ARu DC-Closed Closed Tight � Opeaed at Opeaed at �sid �� +� �d¢� � � �- -O sid �sid The above is catified to be true. ��,.►-�e�.-� C o�'v.✓�-�^c��1 CGtifiod TeslC ��"''� ��b�-IC_ Firm Na�e 1 _ l�i o� 5. C-,e��t -eXP�� '*�aw Firm Address l^'�_k��NT ! - Cat Tater No. ��y 39`� Date_ Gauge � ��3 ��-3�3u llate last accuracy tested � �3 �� White - Cu.stomer's Copy Yellow - City Copy Pink-TesteNs Copy �� C�IECK ONE: IRRIGATION DOMESTIC � FIRELINE BACI�LOW Pi�,VENTION ASSEMBLY TEST AND MAIIVTENANCE REPORT' NAI�OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE: �v�5 S� �-� �'�" �ir�K. � Tbe bacl�low preveation assembly detailed beloa has beea tested aad maint�n� � � by TNRCC regulauons aad is cerdfied to be operating within acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Principle � Pressurc Vacui�Break,er � Double Check Valve o Atmosphere Vacuum Breaker Maaufact�aer ��-� Siu �/�� Modei Ivumber -(I�O ��-( (�� Locat�d At �1�xi��. ��k.-i� �c�1-�S Serial Iv�ber 3� °�7 �� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Doubie Check Valve Assembly lst Check 2nd Check Relief Valve Air Inlet Check Vaive Inival Test DGClosed Closed Ti,Pht ❑ Opeaed at ed at 3'� flsid Ti�t ❑ Leal:ed o __Dsid �,,,psid Cv��//S RP- nsid I,�;� p Did not Opm ❑ L,eal:ed � �� and Mataials Used Test Aft,er DC-Closed Closed Tight o Opeaed at Optaed at __nsid Repair Tight o nsid __nsid RP 'd The above is catifiod to be true. Firm Naa�e L�,+.�-�,r Cc�rr+c�,'�1 Certified Testa r��- ��`-�- 1�� `�- ce,v�� f('�� # 3� Firm Address M'►=-� T5� Cert Testa No. � �0) ? Date_ (3suge # ��(��v3c� llate last accuracy tested � �3 /5 White - Customer's Copy Yellow - City Copy Pink-Tester's Copy � �� C�IECK ONE: IRRIGATION DOMESTIC X FIRELINE BACICF'LOW P�VENTION ASSEN�LY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCAT'ION OF SERVICE: Iv� �• ��.��- I � ^� �'� The bacl�low preveation assembly detailed below has bcea tated aad maintain� � nq� by TNRCC reguladons and is cerdfied to be opaating withia acceptable parameters. TYPE OF ASSEMBLY C Reduc,ed Pressure Principle C� Pressure Vacu�Breaker � Double Check Valve o Atmosphere Vacuum Breaker Maaufacuaer ��r.�� Siu ��/ " Model Ni�ber �� 08 Q L G�T Locaud At �h��►�t, ,�►�.�� i�, coo��e�S Scriai N�ber Oo 1 b o REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BRF.AKER Doubie Check Valve Assembly lst Check 2ad Chec]: Relief Valve Air Inlet Chetk Valve Iniaal Test DC-Closed Closed Tight ❑ Opened at Opeaed at �:�._Fsid Tight ❑ Leal:cd o __Dsid osid �la��s �-_,ps�a I,�;� p Did aot Opea o L,eaked o �P� and Materials Usod Test Attet DC-Closed Closed Tight o Opeaod at Opeaed at �sid Repair Tight o �sid osid Rp sid The above is catified to be true. Firm Na�e ��`ar C��^�� Catified Tata �� `-'c �-r'ioo S. C�P.1.c,� �Q�Pwy -�i'3ao 2 Firm Address ✓`^��:�''-�x T-f- Cdt TesterNo. �,P�o1Ll 3��1 Date �8� � _a��a��3� Date last accuracy tested � l3 �� White- Customer's Copy Yellow - City Copy Pink-TesteNs Copy �� C�iECK ONE: IR.RIGATION DOMESTIC FIRELINS BACI�Z.OW Pi�,VENTION ASSEMBLY TEST AND MAINTENANCE REPOR? NAME OF PWS: CITY OF COPPELL PWS I.D.# LOCATTON OF SERVICE: I��`� 5• ��''�' �-��" I 1�- `S��• The bac1�low preveation assembly detailod below has been testod aad maintained as require� by TNRCC regulations aad is cerdfied w be operating withia acceptable parameuers. TYPE OF ASSEMBLY e Reduced Pressure Priaciple � Pressure Vacu�Breaker ❑ Double Chxk Valve o Atmosphee Vacuum Brealer ��a �, Maaufactiaer W��k� Siu Model Number �.1-�� Q l, QT Located At Ub�-c� vJ�,��, �'-� �c�l-er-- Scrial Ni�ber ��ass REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSiJRE V�CUUM BREAI�R Doubie Check Valve Assembly lst Check 2ad CCbecl: Relief Valve Air Inlet (;heck Valve Inival Test DC-Closed Closed Tight ❑ Opeaed at Opeaed at '1_.Pnd � a�1� Tl�ht p Leal;ed o __nsid _osid / / R.P-_,psid �;� p D i d not O p e a o L e a l:e d O �P� and Materials Used Test ARtt DC-Closed Closed Tight o Opened at Opeaed at _�sid Repair Ti�t o nsid _�nsid Rp 'd 'Ibe above is certified to be true. FirmName f rn�+`�,-' �v."'`•"�-��,�:.1 CatifiedTesta I�oV-`'� �'`'� JS vc� 5. �-Q.�-�` �.��'�y �3c;� Firm Addres,s �''��'�s�"--�.v=� Cert. Tester No. ��y 3`�� Date_ �g� � o� �a �3a Date last accuracy tested 3 �3 �� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy ��`, C�IECK ONE: IRRIGATION DOMESTIC FIRELINE BACT�LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPOR? NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: C��`f S: �3-e l�- I�r� (��- The bacl�low prevmtion asscmbly detaile� below has beea tested aad maintained as required by TNRCC re¢ulauons aad is ceztified to be operating withia accaptable paramcters. TYPE OF ASSEMBLY e Reduced Pressure Principle �, Pressure Vacu�Breaker D Double Chcck Valve o Atmosphere Vacuum Breaker Maaufact�uer 1/�� Siu 1 " Model Number ��o "°`''� Q� Locatcd At �b��2 t.J��1,. 1��y Scrial Nimmber �Co 1�� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check Valve Assembly lst Check 2nd Checi: Relief Valve Air Inlet Checic Valve Ininal Test DC-Closed Closed Ti,Aht o Opeaed at ed at � . �_psid Tight ❑ Leal:ed ❑ _�sid �sid ��2(,,�/� RP-_psid �;� p Did not Opea O Leal:ed O �P� and Mataials Usod Test After DC-Closed Closed Tight o Opeaed at Opmod at �sid Repair Tight o flsid osid RP sid The above is cerdfiod to be true. Firm Name �a��"�"' Cv�m-�,�.� Catifiod Testa 1�4�..�or� 3rzx� 1 Soc� 5. �.e�+"� -e�p�y �T�� Firm Addcess '''"=r�,r 1� Cert Testa No.`l ao1 a Date__ Gauge # ��1�3�� llate lsst accuracy tested � /3 l � White - Customer's Copy Yellow - City Copy Pink-Tester's Copy