Loading...
2014_1006 _ _ CFIECK ONE: IRxIGATION DOMESTIC FIRg�g" X BACI�LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAIv�OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE:�s.�ates of Coppell 1007 Independence The baci�low preveation assembly detailed below has baa tested aad maintaine� as requimd bv TNRCC regularioas aad is catified to be operaring withia acccptable parameters. TYPE OF ASSENNiBLY C Reduced Pressure Priaciple e Pressure Vacu�Breaket � Double Check Valve ❑ Atmosphere Vacuum Breaker Manufact�aer � Siu ��r Modei lvumber �`W� Located At �� � l rll�C.tPX�ttiAQ.Y1CQ �l,"laf ZT�, �(.Q l 0� U Seriai N�mmber ', REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUiJM BREAI�R ' Double Cbeck v aJv�Ass�bly ' lst Check 2nd Cbeci: Relief Valve A'rr Inlet Check Vaive Initial Test DC-Closcd Closed Tight Openod at Opeacd at osid Tight �.� Leal:ed ❑ nsid _.�nsid Rr- ��a a•� , Leal:od � Did not Opea ❑ Leal:ed � I �� � , Materiats ' U� Test Aftar DC-Closed Clased Tight o Openod ac Opeaed at _�sid Repait Tight a �sid osid RP sid The above is catified to be a�ue. , Fiffi1 N�IDel-AFire&Domestic TPS''t�ng Cectified Tester I Firm pddt�s PO Box 7 9 5 4 8 Cat Testa No.BP 0 015 3 8 5 DatC ��r� � Fort Worth Tx 76179 Gauge # 06070576 Date lsst accuracy tested 12/3/13 White-Customer's Copy Yellow -City Copy Pink-Tester's Copy