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2014_1106 (2) C�IECK ONE: '� IRRIGATION DOMESTIC '` FIRELINE Y ,: ` sAc�;ovv p�vErrriorr��ss�rsiY�5��vn�nv�rEN.a►xc��oR� ` , . � � NAI�OF PWS: ; CIT�'OF �'OPP�LL � ����°�I L:t-- C f�.�+`1�=�r(� ) � • 'h. PWS I.D:# _ ' . _ LOCATION OF SERVICE: � �C� �UTk� �?P�(� !(�. � The bacl�low preveation assembly detailed below has beea tested aad ma�nta�n� � nq� bv TNRCC re_eulauons aad is cctified to be operating within acceptable paramettrs. TYPE OF ASSEMBLY e Reduced Pressure Principle ❑ Pressure Vacuimm Brealcer _ _ _ � - �vubl�Chcck Valve - _= o Atmosphere Vacuum Hreaker IGtaaufactsaer ��S Siu �'/� �� Modei N�ber o�� ��2'� 1 Located At '/F� �Y�?�,� ����.�I �. Serial Nimmber ����� \ REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Check Valve Assembly lst Check 2nd Chec�: Relief Valve Air Inlet Check Valve Ininal Test DC-Closed Closed Ti;ht � Opened at Opeaed at nsid �� Tight� � �( Leal:ed ❑ �sid _osid RP-_psid a �� o �` � Did aot Opea o L,eal:ed o �P� aad Matarials _ Used _ . _ _ ..__ , _ ._ . _ _ Test At�er DC-Closed Closod Tight o Opeaed at Opea�at �sid Repair Tighi o �Dsid _nsid - RP sid The above is catified to be true. .r _ � Firm Name �F��,���. � :�'�t( Cadfiad Teste N��" �.� Firm Address `/N'4� �� ,�F���S Cert.Tester Na ��b(� D� �� I Gauge # ���� �r?� Date last accuracy tested �¢ 2 t� ��'�3 White- Customer's Copy Yell�w - City Copy Pink-Tester's Copy