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2014_0905 C�IECK ONE: IRRIGATION DOMESTIC FIRELINE � BACKFLOW PREVENTION ASSEMBLY TEST AND MAIIV'I'ENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATIOIv'OF SERVICE: ���' �� /�°�� �� � The bacl.�flow prevmtion asscmbly detailed below has been tested and maiatained as required by TNRCC regulaaons aad is certified to bc operating withia ac,ceptable parameters. TYPE OF ASSEMBLY e Reduced Pressurc Principle C Pressure Vacu�Breaker � Double Check Valve a Atmosphere Vacuum Breal:er � � rr Manufact�uer r` ���' Siu Model N�ber � D� Locaud At l�'- 5 ic�� �/��'�� Serial N�ber f� � � � � REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUITM BREAI�R Double Check Valve Assembly lst Check 2nd Checl: Relief Valve Air Ialet Check Valve Ininal Test DGClosed Closed Ti;ht �' Opeaed at Opeaed at osid Tisht �' � � Lcal:cd � f� ❑ Dsid nsid R.P•__psid �;� ❑ Did not Opea o Leal:ed � �p� � ����9<le/ �� 5� Ceac,�`'� and Materials Used Test After DGClosed Closed Tight o Opeacd at Opeaed at �sid Repair Tight � nsid osid RP sid The above is catified to be true. Firm Name �''��T���c.- �'/K� CettiSed Testet I2?i�i� �"�r����'` $ Firm Address ��- /��',x 7�7 G��X�-7�� Cert. Testa No. �3��ao 01 c� D� y� S.�c�- (3suge # �G l��/ / 7 �L� llate last accuracy tested � � 7 �� White- Customer's Copy Yellow - City Copy Pink -Tester's Copy C�IECK ONE: IRRIGATION DOMESTIC FIRELINE x BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATIOIv'OF SERVICE: � � �� l��`l����" r The bacl�low prcveation assembly detailed below has bcea tested aad maintained as required bv TNRCC rcgulations and is cmified to bc operating within acceptable parameters. TYPE OF ASSEMBLY e Raiuced Pressure Principlc � Pressvre Vacu�Breaker `� Doublc Chxk Valve a Atmosphere Vacuum Breal:er � �` Manufact�er �'';���K 5 S� � ' �/ �/,�� /� Model Number 3 �� Located At 0�. 5/ e Serial N�ber � � � �� �� � REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUtTM BREAI�R Double Check v alve Assembly lst Check 2nd Checl: Relief Valve Air Inlet Check Valve Initial Test DGClosed Closed Ti;ht � Opeaed at Opened at osid Tidit. � Leal:ed�, �' ❑ �sid nsid RP- `�'d Dsid � �;� p Did not Opea O Leal:ed � Rtpair5 ���''y�c�r (�S � L�l��� and 6 Materials �"���u- e e� I�5 S���� y Used Test Af3er DC-Closed Closed Tight ❑ Opmed at Opeaed at �sid Rtpair Tight ❑ �sid nsid RP sid The above is certified to be tcue. Firm Name �����''� l'/�` � Cerdfied Tcsta 1�'�'�/`�- �'�i�/'��,`"s. �� �o x �� 7 l,U,�x��.. 13�a�aoT�1- � -,� �i� Firm Address � � � Cat Te.ster No. Date Gauge # l.��G��// 7�d llate last accuracy tested � -�� ��� 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 REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: �� ��` �-���f��L� � The back-flow prevmtion asscmbly detaile� below has beea tested and ma�nta�n� � nq�� by TNRCC regulauons and is cerdfied to be operating within acceptable parameters. TYPE OF ASSEMBLY C Raiuc�Pressurc Principlc � Pressurc Vacu�Breaker � Double Check Valve Q Atmospherc Vacuum Breal:er i r' Manufact�uer ��,�10 Siu �� Model Number �� � Located At �^� S/c% ���'v �� Serial Nimmber � � ��`� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check v alve Assembly lst Check 2nd Checl: Relief Valve Air Inlet Check Valve Inirial Test DGClosed Closed Ti;ht � Opened at Opeaed at osid Tisht 3' � � Lcal:ed o? ,� o osid nsid R.P-_,psid �;� ❑ Did not Open O Leal:ed ❑ �P� and Materials Used Test Aftet DC-Closed Closed Tight o Opeaed at Opeaed at �sid Repair Tight ❑ osid osid R.P sid The above is certified to be true. Firm Name ����e�,� �'/'� � Catifiod Testa /�`�� I�`-- ��!. /�, �`� s Firm Address 1' �./3�1� 7�7 ��i9'X9- T� Cat Tcsta No. /3/���'`�o Zca�- Date `�� "s" �� Gauge # (,�G�`f/7 �d llate last accuracy tested � �����'ry White- Customer's Copy Yellow - City Copy Pink-Tester's Copy C�IECH ON& IABI(3ATiON DOMBRl',[C FI$ELiNB 1/ SACKFLOW FREVRNTTt�I A�I.Y 1'EST AND M�A�'�1YE'NANC'�RSl4RT N,�p�p�: CITY C1F CQPPELL PWS LD.� LOCATION OF SERVICE: j�s� � � � Tbe b�d�r � �1Y � b�o`w lu� beon t�s�md ,md mai�iae�d as �ed bv TNRCC i+e�am aod�oea�i�od�be op�•vithi�ao�bia pa�m�'s• TYPE OF ASSEhiBLY � e �ed Pre�ae Priaci�tle e �e Va�a Dcwi� � � Do�k C1�ock Vatve o Aamos�Yaan�m B�aaiaer � !� , s'IZZ T �� � �r� ��� �.�``' r.,�►�At �t,(�'-�.. ►/'�,� � i��'� B�� o�{� �✓�.e,�.�. � �« s�x� ,�. �.-�—..T� � �� RFDLTCED P'RESSiTRE P�it'�LE AS�iF.MBLY PRES5i)�tE VACWM B�AI�R . i/�L.��s�ti`� ..''/ lst C�Ck Zad C'�ec�C �-. �Yst�! Aiu'L�et G�dI vah►t taioai Tast DC-Cto�ed C�o�ed Tig� D �paaed at C)pmed rt ,,,_��� �-ZS-1�- O Leak�ed 0 _�,,,,,.�aid _,._.,�si�d -�__,_�s�d L,ealmed o ���P� � � � �� aod � LJ�ed T�t A�er DC-Cla�od C1o�ed Ti�u o O�ed at O�med�t ._.,,��sid � �� o � �� . �_. RP T'he aboae�a�oo be orue. Firm Nar ��s-----_�'`e-f�r-me Car�d Te�r �••.�cc _.__ ..._^.�� �� �g�,.. ��� _ c�s.r�xo.�� �� n.o��� �'� ��, -Tx . -�s�� cau�e # D 7�1d��'�' D.t.lart.e�ur.cy t..tra,�- i�-l.� White-C�stomor"a� Ye�ow -Cihr�PY �-T���`�P'�► c�Bcg ox$: rxa�ae�ox no�Bs�ric �xs�axs t/� BACKFLOW PREVENTION A�LY TES?AI�iD MAiriTEtYANCB R�PORT N,r�p�pq�: CITY OF COPPELL PWS LD.# LOCATION OF SERVICE: ��sj l� � !� Tbe bacYtiva► p�cn �mhlY d�aiMd bdaw hs� bema tao�md sad maiat�i:md as r�qeated bg TNRCC r�md�catifle�d�c ba op��r�n scc�bla F�me�- TYPE OF ASSEMHLY � c R�Camd Pr�+e Prmciple � Pr�v�nnm� ' � Doub3c Chocic VaIwe ❑ Aamo�V�H�c � Gv��,:.,. s�u 3T�. M�odd Niaaber �3�v�L __ I,acued At /i�d►�.G�� V� Saial N�bec �- 23 � �� RgDUCED P�tESS�JRE P'RINCIPLE AS�SEI4�LY PRESSUxE VAtVtJM BRBAI�R . i�i��� •�� .�'J lst t�lc 2 .2 1�ad C'�ck /�� �Yad�e Air ldot C�a�ek V�ir� �aio�t Teat DC-Ckued Ti�t 4pe�ed a2 Q�x�ed x ---�°-nd g.as-��- � � ° �d �-'d j,� o Did nc�t O�e�n CJ L�tiead D �� aod A�s U�ed Te�t Al�ar DC-C1o�ed Ckued Tigiu o Operied� Ope�ed� ..._n�id R�ic ?i� o —.�� —°� RMP Tbe abvv+e s aacd��ed o�ba aue. F'em Na� •4r����e,�me CatiS�od Tea� �•,�cf� ��-^� � ��,�►a,��,.�.. ��7 c,e�.Te�xa.��7��' r� r,��, -7x . -�s�.� aaug� # D 7�0��� l�ttr Lirtt t�ura�y t�st�d� -� w�te-e�o� co�, YeuoN -cft�,co�y �-Ta.t� copy C�IBCH qNBt IR$IC3ATION DOI`BSTIC FI�BLiNE 1/ $AQQZOVW FREYENTI4ri ABi�h�I.X TEST AND MAINI'ENANCE RSlOAT N,�,�pg p�: CITY OF COPPELL PWS LD. � ��3 S�/ � LOCArION OF SERVICE: /S �� The b�d� p��tie�n a�mbly datail�d b�v �t bam tm�d asd ma�aed � nq�ed b�r TNRCC r�laaoeia�d is eard�a�d m be ope��vithm parm►emra. TYPE OF A55EMALY � e R�uxd Preaus�e Priociple a P�re vaa�&edaer � � Donblc Cl�mck Vatve ❑ A�o�pbcn Yac�um�� � �--�.�-�c� Size � r� ._ M�odel Number " �� I.acstod At Gt�.�ca� �t•C� L�� �LGi.-o�.�-Qc_ �;o � - YVc ua� �.(�i� �.� Seriat N�ber ,� 3 33 '? 3/� " � �1 ��- ok C.k� Z 1--e.v� REDUCED P�URIs PRII�IC'iPLE A�LY PRES5URE VACWM$R� . Doable Cbeslc Vah�e A�h' �, ist C3ack ?�d C�c1t R�Yal�e .�ir ldet C�adt V�h►t Iaia�l Te� DC-Clcuod C�d T' 'o Opoaed� 4peoed at ,��sid 8 ZS-�� �'�°� D Leaked o _,_,_.�sid ..'_„oasd RP- o Did aoc opea o Le�ked o �� md �� Used Ta�t AlEer D�-Cla�ed Cloaed Ti� O Opeaed�t O�x�aed� �__Dad R�it Ti� o �� .�°� R,p 'ILe ab��o�ro�ued to be arue. Fe�N�mo,l�c��-�--�_��e�i-aQ,_,_, GatiS�d T�ar =:��,� I�'i�m A�Rv�-. 7�7 Cmt Te�er Na� � 6/,.�' �.�' �� ��, -r� . �s�� � # D7�'1o��� D�t�l+r�t�c�ut�cy tist�d �.-!` Wh�te-Customer's Gopy Yello�v -C#ty Copy P�dc-Tester'a C+op�l e�t$cg ox$: IRRI(3ATION DOht�BTIC FIRELIMB" I! s�►c�,ow r�v�xr�cx�r�LY rrsr��►n�r�ca�roxr N�p�py�: CITY 4F C�PPELL PWS LD. # LOCAITON OF SERVICE: I�3 S/ � � � 'Ibe b�dcfl�v pr�v� naemb�y det�d b�ra► h� b�aa nm�md a�d mai�siaied �a r�q�ad bv TNRCC r�m�3 is t�i8ied�o ba opm�oi�,g w�tl�ot a�pt�a pst�me�s• TYPE OF ASSEIu�LY - c Ro�ed P�e Priacipk e Pr�+e Vacauam� � t�0'� Doubla Cbeck Vaiv�e ❑ Atmo�p�Vaacwm�a � �i�-�i� �Size .'r� -- Modcl Ntm�ber �� I�d At G�•.c,.�' � �� s�rr� T 3 a 6� �ucEn r�v��c���.Y �sstrx�v�,ewM s�� �c�v�� �, i�a� i, a �c� �.Z �v� �� a�v� taitial Test DC-Ctase� �o�ed?i�t Ope�ned� C)peAed rt __,�� T'�t Lvbmd o �id .�id RP-,�,....�aid j� o Dvd not Otxa 0 Latk�ed O �F� a�od � Used 'f�sc A�r DC-Ciasod Cica�od Ti� o Ope,�ed ac Opeood ac ��id � Tit� � -�-� --°ad RP Tbe abo�+e�aarti8�ed oo ba orua F'ea4 Na�me <lr��_�t��e.,i�i-a�__,,, CactiSd T� ���.� ...,,_,_ �Adi+e��,�...,J"�-.?�7'_,_.__ C�rt.Te�ar Na���D�e�' �`f ��, -?-,� . -�s,.� c�� � a-��o��� l�a L�t .ccnu�acy tist+rd � - �o -I� wnite-custQs�s copy Yenow-cit� cvp�r rlmt-Tester�s copp c�iBCg oN$: �a�Ttox Do��c �x�� � BACI�.OW PR1LVl:NT�ON A�LY T85?AND H[AII�I'�NANCS RSK?RT' N�pg pq�: CITY OF COPPELL PWS LD.� i3OCATIUN OF SERVICE: I�3 S/ /� � � Tbe 6�dc8a�► � ��1�' � b�+ hr bem s�md aad ma�d �s �goeod bv TNRCC t,�am�1 is oarsl�ad eo ba opm�i�.v�ac��p+�meor�s• ?YFE OF ASSEt�►�LY � c Re�d P�r�Priaci�p[e e P�re v�� � �0'� Donbk Cbeck Vslve o Aflmosp�ee�Vscw�H� I��ca� �..�'..��.t� 5iu ��__�.___ M�ad�el Number �O�° Loa�d At �'�`-� �.• �� Scriat N�cr � 33 i 2 �GL,v�.�.P,� lo .�a�,C - Y�r� I2'�-�-� -F�- �/� � e,��. m-�.- C.� � l REDUCED PRES.�iI'RE PRII�TC�.E AS�EMBLY �SSLJR�VACUt7M BR�AKBR Doubk C'�ezlc Vs�A�W7 . ist C�ck ?�C�Ck R�Vslre Air L�iet Ch�ck V�d�e 1a�a1 Tmt DC-Closmd Cloaed Ti�c c Cl�eaed u OpeOed a ______,�� � p O ��� ^�id �''-7S-"�- �.,�� L�`. � o � D�d not Open G L,a�ked O �� aad M�t�iala L3�ed Ta�t AlEer DC-Cbsod Claed 1�t o 4P�aed ac O�x�ed� -�----�� � �� � �� �� FrP Z'h�ab�c d eae:ti8�d�o be trt�e. F'am N�eaa �lr�.���e.�me Cacofi'd T�ot �=`��.,��'_.._� r�em��.� ��� c.�.ra�xo.$ �-„� 6��' ��, r`f c�'�, -r� . -�s,.� cau�e � �7o�1v���' Dat� 3Wtt��cwy t��rd C� r /� ->� � Mlhite-C�atome�r"s Copy Yellow -Cfty Cvpy P�k-Tester's Capy c�iscx ox�: �$ra�Ttox ao��c ��x� t� BAC7CFLOW FR�E'V�M'ION A�LY T'EST A►ND 11 CB RSPQRT �p�pq�; CITY OF COPPELL PWS LD.# LOCATIt3N QF SERVICE: ��S/ 1�_.�.(�.f�.� f� 'I'he bid�lv�v pn�►amaan a�mbly deu�7e�d b�a�► � boan t�md md m�d �a requ�ced bp TNRCC r�cm�1 i�ce�ad m ba op�wi��a par�oers. TYP�OF ASSENIELY � c Ra�eoed Pr+�Priaciple e P�e V�&ea�r � t,0'� Double C�Ock Valve ❑ A��aca�um� � � ,l,-z� Sixc ��} .� Modet I3�ber �fl.� � Lowoed At �� �r.� 1��_ � �� � Sa�ia1 N� ,_,_,r..�..,.��� REDUCED P��PRt1�t�CLM.E ASSFi4�LY P�URE YACWM aR�R . I�e C�dc Yslre Aaasl�iT _, i�c� �. �- s.�a c� /, � �,rv� ,+�� t�v�« tai�l Test DC-C&�ed Ti� Opared u Opcaai ac ��sid �-.}�S_�� � � � �.� � _..�... td �d c Did acc Opm o La�ic.d o �� aod �S Used Tdat Al�r DC-Clas�d Ck»ed 1"t�t o Opa�od� O�eaod�t _..._°ad g� �� o �ad �_id 'I'be zbo�ra�aarsi6�ad�o be tru�. Fnm� �-�'�e.,�me CactiB'd T�er �_� ,_ ..._„_,.. . ��,���. ��7 c�.r�rra.�P������l�f ��, -,� . ��s,� Geug�e � D 7�0��d' ]�1►tr Lrt�a�rrrc�l t�t�_,�-/o � White-Custo�er's Co�ry Yellow -Cft�1 Copy P�t-Testae's C.opy