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2014_0730 C�IECK ONE: ' IRRIGATION DOMESTIC FIRELINE � BACI�T.OW PREVENTION ASSEMBLY TEST AND MAIIVTENANCE REPORT NAIv�OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE:ST�G r,i� ,f 7/7�,�e%�,nc� �'a,r?A'�,/�� D/� The baci�-flow preveation assembly detailed below has beea tested aad n�ta�ned as required by TNRCC r�csulanons and is certified to be operating withia acceptable paramcters. TYPE OF ASSEMBLY e Reduced Pressvrc Principle ❑ Pressure Vacuimm Breaker �'''� Double Chxk Valve � Atmosphere Vacuum Breaker � � �� Maaufact�er r--✓�ti �I" Siu Modei N�ber ��}�i�JI i�L r Located At Yi S�✓ ��an'' 6''�S �.� Serial Nimmber -��1� � REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check Valve Assembly lst Check 2nd Checi: Relief�alve Air Inlet Check Va1ve Inival Test DGClosed Closed Ti;ht Opeaed at Opeaed at osid Tisht/ � Leal:ed , o nsid nsid R.P-�sid �,�,� I,�;� ❑ Did not Opea o Leal►ed � �P� aad Mataials Usod Test Aft,er DGClosed Closed Tight o Opeaed at Opeae�at _nsid Repair Tight o �sid _osid RP sid The above is catifiod to be true. Firm Name�I��'v �l/��'! _ Certified Testa J � Y �'�} S�1'cx1� Firm Address��/-�G�<%-y�,re�,;,� T�° Cat Testa No� D Date�/= ,��Oy'� (�suge # D$p L/0�..$'4 Date last accuracy tested .J,�.�� White - Customer's Copy Yellow - City Copy Pink-Tester's Copy � � � .�„�:� � , 4 � � � C�IECK ONE: � IRRIGATION DOMESTIC FIRELINE V BACI�'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PwS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE:,S��tr�n /7�� 3�-If�,,��,�� d��lT,� ��f y The bacictlow prevmtion asscmbly detailed below has beea tested aad maintain� � nq� bv TNRCC < re_guladons aad is certified to bc operating withia acceptablc parameters. TYPE OF ASSEMBLY e Reduced Pressurc Priaciple ❑ Pressure Vacuimi Breaker -e' Double Check Valve o Amiosphere Vacuum Breal:er �i Manufact�aer r`�� r�`S Siu � Modei Number C'"D 7/�?/ G�1" Located At `f ; St-"� �'��.�'I �� /� Scrial N�ber � �(��o�� __ REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check Valve Assembly lst Cherk ?nd Checl: Relief Valv� Air Inlet Check Valve Initial Test DGClosed Closed Ti;ht Opeaed at Opeaed at osid Tishtr Leal:ed � O �sid nsid R.P- �v sid J, �;� p s Did aot Opea o L,eal:ed � RePairs and Materials Usod Test ARer DC-Closed Closed Tight o ppeaed at Opeaed at �sid Repair Tight o �sid osid R.P sid The above is certified to be true. Firm Name�,"��o C�,�l,i°l Catifiad Tessta �� r r r� ,S�f7G�� Firm Address� �'� �G-ru �' ,r c,�k Cert. Tester No.�3�/�l�'b'�G 9 Date � -�-�` a�`�y � (=auge # ��D�_SC� llate last accuracy tested��.�/L White - Customer's Copy Yellow - City Copy Pink-Tester's Copy v., ��:�: �. '., � r C�IECK �NE: IR.1tIGATION DOMESTIC FIRELINE � BACT�LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAN�OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: ��'; �r�rlsi /�/7 �=:1"3e/t�i��%f�o�,�o��°�/T ;�sa i y The bacl�low prcvmtioa assembly detailod below has bcea tested aad mainta�n� � nq� bv TNRCC � re_Quladons and is cerdfied to be operating within acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Priaciple C Pressurc Vacui�Breaker .� Double Chxk Valve o Amnospherc Vacuum Breaker / .r Maaufactsaer 1..�� I' T�' Siu .� Model Ivumber t�O 7/yl/C�7"" Located At Y�'��'✓ �'�7vn/S''/�� Serial Nimmber �n �1' 3r��/ REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check v alve Assembiy lst Check 2nd Chec{: Relief Valve Air Inlet Checic Valve Inival Test DGClosed Closed Ti�t Opened at Opened at osid Tisht Leal:ed ❑ �sid _osid RP- �"�nsid ' I,�;� ❑ � r� Did aot Opea o Leal:ed � �P� and Mataials Used Test After DC-Closed Closed Ti,rht o Opeaed at Opeaed at _�sid Repair Tight ❑ osid osid RP sid s The above is catifiod to be true. Firm Name/�'�c 7`�'v C��ir�/�' Cctifiod Tester-��r r y St/1 GY��' Firm Address��G/.2�7ls ru,.�ur=r��i� Cert. Taster NoL�/�v�� . Date�/�� 9�' Gauge #C' �IIG�y4�S U llate lest accuracy tested ,.5� White - Customer's Copy Yellow - City Copy Pink-Tester's Copy ,�, .,. C�IBCK ONE: �e � � IRRIGATION DOMESTIC FIftELINE v BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAN�OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE:S'T M�r��h I?I 7�,��t/,,��,�',(��,,�,�f/� �,S'o/y The bacl�low preveation assembly detaile� below has beea tested aad maiatained as required by TNRCC regulauons and is cerdfied to be operating within accrptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Priaciple C Pressure Vacu�Breaker � Double Chcck Valve 0 Atmosphere Vacuum Breaker / /� Manufactzaer G.,�r frS Siu � Modei Number �c�� f �� Locaud At �'r SG �- �'0�1Jj7��i�C? ... Serial N�ber �i� �� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACULTM BREAI�R Double Check v alve Assembly 1st Check 2nd Checl: Relief Valve Air Inlet Checic Valve Initial Test DC-Closed Closed Tight Opened at Opened at �nsid Ti�� Leal:ed o nsid _osid R.P-�sid � L/ �;� o ' Did not Opea O Leal:ed � RePairs and Mataials Usod Test After DC•Closed Closed Tight o Opened at Opeaed at _�sid Repair Tight ❑ nsid __,osid R.P sid The above is certified to be true. Firm Name/�/�1 o'e Cc��r's�• Catified Tester J ��`�'c.� SC�t Gb/�. Firm Address�'D,G�.?.� rao�r>r��'��G�r Cat Testa No:�'�r7S�d k�U Date 3�!`�/ Gauge #L`fl J�i�`/D�f�(� llate last accuracy tested :S White- Customer's Copy Yellow - City Copy Pink-Tester's Copy _ ,- , � " �: C�IECK ONE: IRRIGATION DOMESTIC FIRELINB � BACI�LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAI�OF PwS: CITY OF COPPELL PWS I.D. # LOCATTON OF SERVICE•,��Iar,"�+ /�/7�1�e%��'� �dT��r 7�G/� The bacL-flow prcvmtion asscmbly detailed below has beea tested and maintained as required bv TNRCC re�lacions and is cecrified to be operating within acceptable parametecs. TYPE OF ASSEMBLY e Reduced Pressure Principle � Pressvre Vacui�Breaker �'� Double Check VaIve o Amnosphere Vacuum Brea�er r� � �. Maaufactiaer (.�Ol.. �" � Siu , _ Model Ivumber ��1 Q� Located At Y�'S�d'YDU�1'l �'�.�� Scrial Nimmbcr (/� �� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Cbeck Valve Assembly lst Check ?ad CLecl: Relief Valve Air Inlet Check Valve Initial Test DC-Closed Closed Ti;ht Opened at Opened at csid Ti�i Leal:ed ❑ Dsid _osid R.P-�sid l, � �;� ❑ / Did aot Opea O Leaked o RePairs aad Mataials Used Test After DC-Closed Closed Tight o Opened at Opeaod at _nsid Repair Tight o �sid __�osid RP sid The above is catifiod to be true. Firm N�/�`I(A t ro ( �l n/YI Catified Testa �� r ry �!'Ga� , Firm Addres.sa�l�.=�7�c ti,a��QS'9 Cat Tester No��'�OvS�/c�9 Date� Gauge # L� b�l� C/L1{�j�j llate last accuracy tested ,� /� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy ,. - � C�IECK ONE: / IRRIGATION DOMESTIC FIRELINE �.„.,�'�� BACI�LOW PREVENTION ASSEMBLY TEST AND MAIIVTENANCE REPOR? NAIv�OF PwS: CITY OF COPPELL PWS I.D. # LOCATI�N OF SERVICES t.�9�r.� l��7�:,�l�/,��( �'��1��- �soi 5 The bacl�low prevtntion asscmbly detailed below has beea tested aad maintained as required by TNRCC reguladons aad is cerdfied to be operating withia acceptable parametets. TYPE OF ASSEMBLY e Reduced Pressure Principle C Pressure Vacuum Brealcer �e�' Doublc Chxk Valve o Amiosphere Vacuum Breaker / � � I/ Maaufacturer I�JG� rf 5 Siu Modei Number �'`� 7/�'I/�T Located At {'1�S�Y r't�1?1GY��ji� Serial N�ber ��, ,�/'�i1 �� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�CUUM BREAI�R Doubie Cbeck Valve Assembly lst Check 2nd Checi: Relief Valv� Air Inlet Check Valve Inival Test DC-Closed Closed Ti�t Opened at Opeaed at nsid Ti�ht L� Leal:ed ❑ �sid _osid R.P- �� ( Dsid � Lea� a / Did aot Opea o Leal;ed � �� aad Matarials Used Test Afttr DC-Closed Closcd Tight o Opeaed at Opeaod at __nsid Repair Tight ❑ �sid osid RP sid The above is certified to be tnu. , / Firm Name,�G�Y�� G��t Catified Testa �c r �y „�c l�c3G.� Firm Address��l�l,� aT u•r�.,��,�c�t7/G'�� Cert. Tester No.��'�G�S�GG�'1 Date a / (�auge # �'$L��/j� �'.S C? Date last accuracy tested�j� White - Customer's Copy Yellow - City Copy Pink-Tester's Copy C�iECK ONE: : � IR.RIGATION DOMESTIC FIRELINE � BACIQ�'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATTOIv'OF SERVICE: Sr, /�'nr�N /)1 J�'. ,�c�/tf��' ,� t�,T�J�,� 7 S�'/� T'he bacl�low preveation asscmbly detailed below has beea tested aad ma�r+ta�n� � nq� bv 'INRCC reeulauons and is cerdfied to be operating withia acceptable parameters. TYPE OF ASSEMBLY e Reduced Pressure Principle � Pressure Vacu�Breaker 8� Double Check Valve ❑ Atmosphere Vacuum Breaker /� Maaufact�er ��f.�7`�"S Siu .� Model Number L� G �1'� /C�L t" Located At �l�s c r r�am ��t�� Scrial N�ber l.„�r� '� ' REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check v alve Assembly lst Check 2ad Checl: Relief Valve Air Inlet Check Valve Inidal Test DGClosed Closed Ti,,P.ht -0' Opened at Opeaed at osid Ti�ht,� j ' Leal:ed ❑ �sid _osid R.P-�� 7 Dsid � Leai:ed o � � Did not Opea o Leal:ed � �� aad Mataials Usod Test ARtr DC-Closed Closod Tight o Opened at Opeaed at _nsid Repair Tighi o �sid __osid RP sid 'I�e above is cerafied w be true. Fi:m Name,,�n rra Cf�n��9 Certifiod Testc ..�� Y �rc.� �/�U/�. Firm Address�r,�i��(rw��,�c�?��,�� Cert Tester No�Povo�(�O� Date �/� (�suge # Q��/O�SU llate last accuracy tested.� /� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy h � C�IECI£ ONE: IRRIGATION DOMESTIC FIRELINE_�_ BACI�LOW PREVENTION ASSEMBLY TEST AND MAIIVTENANCE REPORT NAI�OF PwS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE:ST;�arii� /�/��. &/rJ'�,� .P� t'Jar��o��If T �.ScI/y� The bacl�low preveation asscmbly detailed below has beea tested and maintaincd as required bv TNRCC reguladons and is certified to be operating within acceptable paramcters. TYPE OF ASSEMBLY e Rcduced Pressure Principle e Pressurc Vacuimm Breakcr ,0� Double Check Valve � Atmosphere Vacuum Breaker � / / '" Maaufactzaer G✓G• fi� Siu � Model Ivumber ��I� � � r Locaud At ��'i�r I"'oc�� S"'�� Serial Nimmber �'��'� �'� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�CUUM BREAI�R Double Cbeck Valve Assembly lst Check 2nd Chec�: Relief Valve Air Inlet Check Valve Inidal Test DC-Closed Closed Ti�ht � Opened at Opeaed at nsid Ti� � Leal:ed o nsid osid R.P- �� sid �,� �;� ❑ Did not Open o Leai:ed o RePairs and Mataials Used Test Ai3er DGClosed Closod Tight o Opened at Opeaod at nsid Repair Tight o csid _._osid RP sid The above is certified to be tcve. ' � ��a��' Firm Name�i�°!`r,� ar�,�`! Certifiod Testa e /' Firm Addres.sPQ[3�2r;7 r�,��...+d T�,Y o�y Cat Testar No.�f%�r��r;G� Dace?s3U�S`` Gauge #Q;��/t7 S�S� Date last accuracy tested,j� White - Customer's Copy Yellow -City Copy Pink-Tester's Copy , ;� C�IECK ONE: IRRIGATION DOMESTIC FIRELINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATTON OF SERVICE:,,�,�c.��i� /7/7��.�c ��i7�A�'ct' C�,p��//�-7St;�l� The bacl�low prevention assembly detailod below has beea tesied aad maintain� � nq� bv TNRCC regulations and is certified to bc operating within acceptable paramcters. TYPE OF ASSEMBLY C Reduced Pressure Principle � Pressure Vacut�Brealcer � Double Chcck Valve ❑ Atmosphere Vacuum Breaker ✓/ Maaufacturer �-�1��, Tr S Siu � Modei N�ber C�,�C�"7d'til l �� Locat�d At Yd�S� r ►'ro� 1S/�°'�/� Serial N�ber ��`� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check Valve Assembly lst Check 2nd Checl: Relief Valve Air Inlet Check Vaive Inical Test DC-Closed Closed Ti�t Opeaed at Opened at nsid Tig� ,3, Leal:ed ❑ osid _osid R.P-'�_psid � , o�'. I,eal;ed o Did not Opea o Leal;ed � �P� aad Materials Used Test ARer DC-Closed Closed Tight o Opeaed at Opmed at _�sid Repair Tight � Dsid osid RP sid The above is catified to be true. Firm Name/��t►'v C��.^_ Certifiod Testc �r r -�c i��a 1! Fi�Addressp�BJ 7��,��„o��o hu T?�00%�' Cert. Tester No.�/��U fi d�� Date �%�S Gauge # � �y4 r/�;�J,SU . llate last accuracy tested White- Customer's Copy Yellow - City Copy Pink-Tester's Copy � A � C�IECK ONE: IRRIGATION DOMESTIC FIRELINE C/ BACI�'LOW PREVENTION ASSEMBLY TEST AND MAINT'ENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATTON OF SERVICE:.��,/►�,-��, /�i 7 �; �/r-/,�� C�,r�,o�/T �,S a�� 'Ibe bacl�low preveation assembly detailod below has beea tested and maintained as required by TNRCC regulations and is cctified to be operating within acceptable parametccs. TYPE OF ASSEMBLY ❑ Reduced Pressvre Priaciple ❑ Pressure Vacu�Breaker � Double Check Valve ❑ Amnosphere Vacuum Breaker � Manufacuaer /��s�1"1`S Siu � /� Model Number QU�/1'Il Gz %� Located At �"� 5 e r roo,,� �/� '�/9 Scrial Nimiber '�8��l REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check Valve Assembly lst Check 2nd Checi: Relief Valve Air Inlet Check Valve Inival Test DGClosed Closed Ti;ht Opeaed at Opened at osid Ti�i Leal:ed ❑ nsid _,nsid R.P-�j� Dsid � I,�,� o f � Did aot Opea O Leal:e� o Repairs aad Materials Used Test After DC-Closed Closed Tight o Opeaed at Opeaed at _nsid Repair Tight o osid osid R.P sid The above is certified to be true. Firm Name �I�1'�Y�a �r?/�'!�. Certifiod Testa �� Sc h aD� Firm AddRs.sPaRi 7 Yr �v,�7k7GoJ'� Cat Tester No.� Date 7�-3U� Gauge #G'�D t/�Q�S G� llate last accuracy tested � White- Customer's Copy Yellow - City Copy Pink-Tester's Copy < .�. �' C�IECK ONE: IRRIGATION DOMESTIC FIftELINE BACI�'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT rr�OF Pws: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE:.�i; /�1c r�'� f 7/7� t3e/.�"�.%1� /�'� �'Q�,�c'/�/�. �5"�J�'-�' The bacl.�flow preveatioa assembly detailod below has beea tesi.ed $ad ma�n a�n� � nq� bv TNRCC regulauons and is certified to be operating within acceptable paramcters. TYPE OF ASSEMBLY C Reduced Pressure Principle ❑ Pressure Vacu�Breaker .er"" Double Chcck Valve ❑ Atmosphere Vacuum Breal:er � /` Maaufactiaer ��i l��S Siu .� Model Number �-�G ?�� / Located At k"► S�r ruo� 8ly �"��d Serial N�ber .��'� �� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Checic Valve Assembly lst Cherk 2nd Checi: Relief Valv� Air Inlet Check Valve Inival Test DGClosed Closed Ti,Qht �" Opeaed at Opeaed at vsid Ti�t � � Leal:ed ❑ nsid _,osid R.P-��sid � i Q I,�;� o Did not Opea o Leal:ed o Repairs aad Materials Usod Test Aft�er DC-Closed Closed Tight a Opened at Opeaed at __nsid Repair Tight o nsid nsid RP sid The above is cerafied to be t:ve. Fi:m Name ,�I�'��i� �G/�'1.�'I Cctifiod Testa �e. Y r rr� ,��D��'' Firm AddressP�6l.�_G 7G��v,r�°7�76o r3 Cert. Testa No..��dD��Date 1.3 UI Gauge # o SU yU SfSl� llate last accuracy tested,3 �j'r/�y White- Customer's Copy Yellow - City Copy Pink-Tester's Copy �. C�IECK ONE: ` IRRIGATION DOMESTIC FIR.ELINE BACI�'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE:.1'7•��cY, i��7�'. �e/jI ha,�r.� �'C�r'1�� SC�/jC' 'Ibe bacl�low prevmtion asscmbly detaile� below has beea tested and mainta�n� � nq� bv TNRCC reguladons and is cercified to be operating within acceptable paramcters. TYPE OF ASSEMBLY C Reduced Pressure Principle e Pressure Vacu�Breaker 2' Double Check Valve o Amiosphere Vacuum Breaker � rf Maaufact�aer � r� Sizt Model Nt�ber C9 C:��,� �i Locaud At Yr`5'� r 1''UO.�'1 8��,2/ Serial Nimmber .��1�`��— REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check v alve Assembly lst Check 2nd Checl: Relief Valve Air Inlet Checic Valve Inidal Test DGClosed losed Ti;ht Opeaed at Opeaed at �Dsid Tight L�,� o vsid _osid RP-�sid � �;� ❑ Did not Opea D Leal:ed � �P� aad Materials Used Test After DC-Closcd Closed Tight o Opeaed at Opeaed at _�sid Rtpair Tight o �sid csid RP sid The above is cenifiod to be true. Firm Name �I�� U/yt/1�1 Catified Testa :�c r��S��G� Firm Add�ess�'GBI°�n�rP�v�hC,lx 71�L��`! Cert. Tester No�f�O � Date�� Gauge # �'-'�D tlo�� llate last accuracy tested��` White- Customer's Copy Yellow - City Copy Pink-Tester's Copy _`�. C�IECK ONE: " IRIZIGATION DOMESTIC FIRELINE BACT�LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAN�OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE:.�>.�,,�o'n /7/7 C�R�/tI.'ti��'c�(�o,��./1 T �.5�/,� The bacl�low preveation asscmbly detailed below has beea tested aad ma�nta�n� � nq�� bv TNRCC regulacions aad is cerd5ed to be operating withia acceptable paramcters. TYPE OF ASSEMHLY C Reduced Pressure Principle � Pmsure Vacu�Breaker 2� Double Check VaIve o Atmosphere Vacuum Brea�er Maaufactsaer �c, r1` 'S� Siu � `� Model N�ber �C, `� Locatcd At Y�� ►� Yd�� CG��'n� s��N��a /3 a c� ��_ REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUiJM BREAI�R Double Check v alve Assembly lst Check 2nd Checl: Relief Valve Air Inl�t Check Valve Ininal Test DGClosed Closed Tight e►' Opeaed at Opened at nsid Tight � Leal:ed ❑ �Dsid �osid RP-�sid �, �) �;� ❑ Did not Opea o Leal:ed o �P� aad Materials Usod Test After DC-Closed Closed Tight o Opeaed at Opeaed at �sid Repair Tight o nsid _osid RP sid The above is cerdfi�to be tcue. Firm Name/�c�"�v C�'orr�rrt Catifiod Testa �e.Y�'�! -��tG�1� FirmAddressP��7trr�.r.r°v�,��TX��9�+ Cert. Tastallo. ��04r��G>�1 Date �,34 / Gauge # G,�'0�/D f��"G llate last accuracy tested / White - Customer's Copy . Yellow - City Copy Pink-Tester's Copy _ �" C�iBCK ONE: �, IRRIGATION DOMESTIC FIRELINE� ��^ :�� / %i'►� BACI4'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: 5� �1�'�;r,��, /?i 7 L: �3� )t/��c.�Pf,� �'��o�//T �SB/� The bacl��low prevmtioa assembly detailed below has baa tested aad maintained as required by TNRCC reguladons aad is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Principle ❑ Pressure Vacu�Breaker .e�'� Double Chcck Valve o Atmosphere Vacuum Breal:er a� Manufact�aer , �e�C n Siu � Modei lvi�ber IJ �' C � Located At � t/.r.xrr,2�t' ��,� Lk,�" <;t��' Serial Nimmber �l�� S�G�-f/ REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�CULTM BREAI�R Double Check Yalve Assembly lst Check 2nd Chec1: Relief Valve Air Inlet Checic Valve Inival Test DGClesed Closed Ti�t �" Opeaed at Opened at osid Tidst s' Leal:ed o osid osid �- ��Ds�a 3,� �;� a Did not Opea O Leal:ed o �P� and Materials Usod Test Aftet DC-Closed Closed Tight ❑ Opeaed at Opea�d at _osid Repair Tight o �sid osid RP sid The above is catified to be true. Fi:m Name/VI��rv Ca�tm Cerdfied Testa��r�`'1 S�/�c�� Firm Addres�''A�/Z��Gr4�c,�.��,�e�T�7(C1�'� Cat Tester No.�l�� Date �..3/ l�/ Gauge # G� �'b�/D`t�S O llate last accuracy tested ��1 White- Customer's Copy Yellow - City Copy Pink-Tester's Copy � C�iECK ONE: IRBIGATION DOMESTIC FIRELINE j/�, ,�H,�y! ;j� C' [�, �?�SS BACIC�'LOW PREVENTION ASSEMBLY TEST AND�NANCE REPORT NAIv�OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE:,5�,�`,f��r,n/7/��f3��/�%h�/��('a Jo�c��T .75�'/� The bacl�low prevmtion assembly detailod below has beea tested aad maintained as required by TNRCC regularions and is cercified to be operating within acceptable param�. TYPE OF ASSEMBLY C Reduced Pressu�e Principle C Pressure Vacutmm Brealcer �''� Double Chcck Valve ❑ Atmosphere Vacuum Breal:er � �� ,� Maaufactiaer i-. l�r� l`7`S Siu Model Ivumber !%f"�/�9�Z C�' T Located At �, U..0�# �� '��t� y� �� Sezial Nimmber ,/�� 3� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Check Valve Assembly lst Check 2nd Chec{: Relief Valve Air Inlet Check Valve Inidal Test DGClosed Closed Ti;ht Opened at Opeaed at esid Tight Leal:ed o nsid osid R.P- s�' �Dsid Leal;cd O �� Did not Opea o Leal:ed o �P� and Mataials Used Test After DGClosed Closed Tight o Opeaed at Opeaod at _nsid Repair Tight o osid �sid RP sid The above is cati6ed to be t:ve. Firm NamelylG�'�'� ��h�l_ Catifiod Testa ��Y�.S�.�ia�' Firm Address�o�y��~� � �r ( Cert. Testc No._ ��'08'GCo� Date 7/3/ /y (�auge # �U�O �� v _ llate last accuracy tested ,� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy C�iECK ONE: � IRRIGATION DOMESTIC FIRELINE , , / �� ► �, �� BACKFI�OW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAIv�OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE:i�r, /�E�rx`h /�/� LL��t�h�.�"o� �'�,��1/7� ��0�9 The bacl�low preveation assembly detailed below has been tested sad ma�nta�n� � nq� by TNRCC regulanons aad is certified to be operating withia acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Principle e Pressure Vacu�Breaker 2'' Double Chcck Valve o Atmospherc Vacuum Breal:er ��i Maaufacuaer � _C' l'r� _ Siu Model Ivumber _ �C � Locaud At �cJ �,�„r��t��'l�.v� �'�,�r�1nc c� s��N�ba �c�D �� 3 REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACULTM BREAKER Doubie Check v alve Assembly lst Check 2nd Checl: Relief Valve Air Inlet Check Valve Inival Test DGClosed Closed Ti;ht Opeaed at Opened at osid Ti�t Leal:ed ❑ �sid nsid RP-3,� �sid , � � 3 ,� Did noc open � L,eal:ed � � �P� and Mataials Used Test Ai3er DC-Closed Closed Tight o Opened at Opeaod at _�sid Repair Tight ❑ �sid esid RP sid The above is certified to be true. Firm Na�s G IY� ��„o�. Certified Testa �G r►�H -SC��'CJ� Fitm Addcess�'oB/z_�7�xt`T��re��(�� Ce=t Tester No.�/�OGi4`dli�i✓� Date �� f Gauge #�'�'O c/G�,��/' llate last accuracy tested �S� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy _. __ . � C�IECK ONE: IRRIGATION " DOMESTIC FIRELINE �r'��,� .'7 �j� � l,.,,�� /�� Ss� BACI�T.OW PREVENTION ASSEMBLY TEST AND�NA�CE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: �7 /�IG�✓� ,n /��/7��.�c/ff��'�P C��r��/��7.SfJJ�i' The bacl�low prevmtion asscmbly detaile� below has bcea tested aad maintained as required by TNRCC regulanons and is cerdfied to be operating within acceptable paramcters. TYPE OF ASSEMBLY e Reduced Pressure Principle C Pressure Vacuimm B� ,� Double Chcck Valvc ❑ Amiosphere Vacuum Bnal:er Maaufact�er /�eC,..�`�� Siu �/�1 �� Model Number L% 1,?l�'12C�� Located At a�}�U�al�L�I'c�' ��c:,��c;' Serial N�ber C1�� L�� _. �'� REDUCED PRESSURE PRINCIPLE ASSEM$�Y PRESSURE V�CUUM BREAKER Double Check Valv�Assembiy ; lst Check 2nd Checl: Relief Valve Air Inlet Check Valve Inival Test DC•Closed Closed Tight a.� Opened at Opened at osid Tight ❑ Leal:ed o" �Dsid nsid RP-�sid �, � �;� ❑ ' Did not Opea o Leal:ed � � ��.-�_ RrPair� � aad Materials Used Test Af3,er DC-Closed Closed Ti,pht o Opeaed at Opea�at _osid Repair Tight o �sid _,_,osid R.P sid The above is certifiod to be true. Firm Name�"/t'/Yca C [l/�/s'J _ Certified Testa `��r re�}��i?d� Firm Address�ti8/1 e7(ra�ev i�c.7r7/��, Cert Tester No.�P�'f�l�Date� .3/ � Gauge # C��(;��,lQ k�� llate Isst accuracy tested� 5 White- Customer's Copy Yellow - City Copy Pink-Tester's Copy