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2014_0618
CHECH ONE: IRBIGATiON DOMS81'iC FIBELINB � a�c�.ow rx�v�ox��L��sr� c�xEeoirr NAI�+�OF P'WS: CITY OF COPPELL pws i.n.# ����� � � �/� J 3`�SS LOCATTOIs OF SERVICE: �g� ��lt/ ��/v �,� � TLe bad�lorov p�evemiww� as�bly d�led bdo�v �as bxn te�ed and mai�anoed as mquirod by TNRCC n�a�d is oa�tifiod to be opa�iag�n ao�bk pna�s- TYPE OF ASSEMBLY � c Rcd�Presso�e Priacipk e Pr�ae V�Br+ealaer � Donbk Checic Valve ❑ Atmosphcre Vacm�m Br�aioQ � G�.e.� s� �l� M�odd Numba �p�!� 3 La�ated At �S,€ . �'�•�� serist N�ber Z-9 0,� c�Z. REDUC�PRES.Si�tE PRINCIPI.E ASSEMBLY PRES.SURE VACWM BRE�II�R _ no�c�v��r . isr C7�ecic /• � 2ad C�edc 2�. g�f VaMe Air Inkt fbedc Vah�e Iaroiai Test DC-Closed T�i�t Opeoed at Clpwed�t ��sid T;� � o nsid �d � � Did noc Opea o i,�aloed o �� a�d l�t�ials Uaed Test A�er DC-CI�ed Clcaed T�ght o O�eood at Ope�ood at �sid � �� p oaid �sid RP T7�e aba�va is c�ati6ed�o be onx. F'am Name ����•�- �� �-�'�� Catified Te�s�er f-�.P' n r1�7�'1� �o��- F�� � � �.T��.�P���s�� 3� � r� w�����-, �si�� � G� # o ������� DBte last accuracy tested � �/�- /�-t- White-Customer's Copy Yellow -Cftp Copy Pi�c-Teste�'s Ccpy