The URL can be used to link to this page

2015_0202 (2) �� C�IECK ONE: IRRIGATION DOMESTIC FIRELINE� BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT N,�oF Pws: CITY OF COPPELL PWS I.D.# G� � �� LOCATTON OF SERVICE: /� c�-� �� S�U/cl The bacl.�tlow preveation assembly detailed below has bxa t.�sted and ma�nrain� � nq�� bv TNRCC reguladons and is cerdfied to be operating withia acceptable parametcrs. TYPE OF ASSEMBLY C Reduced Pressure Principle ❑ Pressurc Vacuimm Breaker � Double Chcck Valvc ❑ Amiospherc Vacuum Breaker �/ // Manufaetiaer � Siu � Model Ni�ber �O / m �, Located At �� Scrial N�ber ��U REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check Valve Assembly lst Check 2nd Checl: Relief Valve Air Inlet Check Valve Initial Test DGClosed Closed Ti�t Opened at Opeaed at �sid Ti�t Leal:ed ❑ �sid _nsid Pa�� _-ps�a Leal:ed ❑ " Dia noc Opea o I.eal:ed � �P� and Materials Usod Test Aft,er DC-Closed Closed Tight o Opmed at Opeaai at �sid Repair Tight ❑ �sid __nsid RP sid The above is cctifiod to be t:ve. Firm Name � � ,�`r�i P�. Certifiod Tesca r�' 6 lG-5 Firm AddrGss P� f'7�X ��Y �;l �:�7,^ Cat Tester No.� Go 3�53 Date�`�J�— i�!. ?S"/G�i Gauge # 3��''(� llate last accuracy tested —� �� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy