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2015_0320 (2)
C�IECK ONE: IRRIGATION DOMESTIC FIRELINB � BACI�LOW PREVENTION ASSEIV�LY TEST'AND MAINTENANCE REPOR'T N�ME OF Pws: CITY OF COPPELL PWS I.D.# LOCATION OF SEKVICE: 1��� Crn��sv6 0 �2• Tl�c back�flow prcveadon asscmbly decailod bclow has baa tested aad maintai�d as required bv TNRCC n�lations aad is certified W be operaang arithin acceptablc parameters. TYPE OF ASSENNIBLY e Reduced Pressure Principle e Pressure Vacau�Brealoer � Double Check VaIve o Atmosphere Vacerum Bnaker Maaufacu�cr �lJc��S Siu �„ M�i r�� 75� �a At G�.e v�,� l�- �?2a�� - - � s�r+�« �c/�-0�3� REDUCED PRFSSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BRF.AI�R � Double Cheek Valv�Assemblp �s lst Check �nd Checl: Rdief Valve �1ir Inlet Checic Valve Iaitial Test DC-Closed��� Closed Tight �f Opcaed at 4Peae�ac �d T i�h t � Leal►ed � � o nsid nsid RP-,�psid � ❑ Did na Opea o Lealed � �P� aad Mataial5 Usod resc After DC-Closed clasod?ight o Opeaed ac Opeaod at �id Repair Tight � �id �osid RP The above is certifiod to bc we. Fism Name �i-�f�r�►� �v e. P2DS Certified Testc `�GtSc�� ttvSTon� Firm Address I`-'0,�i� 797 ( /r�S��2aCh�p Cert.Tester Na �P l i b��1 Date T� cauge � D!o//D()`75 llate lsst accuracy tested�� T�