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2014_1106 C�iECK ONE: IRRIGATION DOMESTIC FIRELINE � / � ",4: BACKFLOW PREVENTION"�1SSEMBLY ST AND MAIIVTENANCE REPORT NAME OF PWS: CITY OF' �OPPELL �-�`r�f.:�. Ci �(`�--fL.� : - � PWS I:D.# LOCATION OF SERVICE: �I �O �OU�`� `--�1'�F (.L �� The bacl�low prevmtioa assembly detailed below has beea tested and maiatained as nquired bv TNRCC reguladons aad is cacdfied to be operating withia acceptable paramcters. TYPE OF ASSEMBLY � Reduced Pressure Principle _ C Pressure Vacq�,Breake; ., - . ,; ,. _ .: -_ _ . _ ; _._ -.�4...__ • Do�ble�Chcck Valve :_,: __;�.____ p , �. . #�a�3b�re Vacuum"�Breaker , Maaufacwrer � Siu b ,. t� . t��--� D(�-�� P�2a�I�(,�.t:�2 �1t�.._�Ir:y. . . ; Model Number ��X �� n Located At __ y�.�.�.�,� .��, Serial Nimmber �� 1 � REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�CUUM BREAI�R s . . . � . . . . . . . - :9 � . .. . � . . � . . � � i " Double C1eck v alve Assembly , : _ } , a 1st Cherk 2nd Ched: Relief Valve ' Air Inlet Check�ah►e < Inival Test DGClosed Closed Ti,pht 24 Opened at Opened at osid Ti�t x1 Leal:ed ❑ �sid osid .�. �,�,'�j� ;R.P- ��sid 2 � 0 3`J Dia nac opea o Leal;ed o _ .. RePairs - aad Mataials � - ,.; ��_ ---:: � , _,, _ __ ,, ,_ ,_ ,� .-: r -�_,_ _ �� . - :' Test Aftet DC-Closed Closed Tight a Opened at Opea�at �sid Repair Tighi a , osid osid RP sid .R The above is cerdfied to be we. ~ .�, r _ r � Firm Name_1 t�"'�!�,�I'�X_ �i ��`( Certified T 1 I� � . �� . � � 1� .�+� . � � Firm pddress ��1�.h� ��"'X�'�7 Cert Tester No. �tg Date � Gauge # 1�.��l� ! llate last accuracy tested �� -� �17 White- Customer's Copy Yellow - City Copy Pink-Tester's Capy