2014_1006 ____ _
C�IECK �NE:
IRRIGATION DOMESTIC FIgELINg" X
BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPOR?
rraME oF Pws: CITY OF COPPELL
PWS I.D.#
LOCATION OF SERVICE: Estates of Coppell 1007 Independence
The bac�low prevmdon assembly detailed below has boen tes�ed aad ma�*+� ��*� as required bv TNRCC
re_�iladons aad is ce:tified w be operating withia acceptable parameta�s.
TYPE OF ASSEMBLY
e / Reduced Pressure Priaciple e Pressure Vacuimm Br�aker
3' Double Check Valve ❑ A�osphere Vacuum Breaker
Maaufactsaer 1r,YY1C.J Siu ���
Model Ivumber �'O!o �. Located At J d 4����p.�(�� 1�-�-'
Serial Nimmbcr I� II✓ 1 ,
REDUCED PRESSURE PRII�ICIPLE ASSEMBLY PRESSURE VACLTUM BREAI�R
Double C3eck�alve Assembly
lst C3eck 2nd Checl: Rdief Valve Air ldet Check Valve ,
Initial Test DC-Closed Closed Ti�ht Openod at Optaed at osid 'I
Tight 1 •`� Leal:od ❑ nsid ,__�nsid
R.P-�psid �,�/
Leal:ed a Did noc Open ❑ Leal►ed o
�� i
aad �
Materials '
. U� ,
Test AR�et DC-Closed Closed Tight o Optaed at Opmod at nsid ,
Repair Tight a �sid osid
RP sid '
The above is certified to be�ve. '
i
FicmName�-AFire&Domestic Tes''ting Certified?esta ' �
Fitm pddress P 0 B o x 7 9 5 4 8 Cest T�No.BP o o i s 3 s s Date�,�
Fort Worth Tx 76179
Gauge # 06070576
Date last accuracy tested 12/3/13
White-Customer's Copy Yellow -City Copy Pink-Tester's Copy