Loading...
2014_1006 __ _ _ C�IECK ONE: IR&IGATION DOMESTIC FIRI3LINE` X BACI�LOW PREVENTION A55EMBLY TEST AND MAIIVTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE: �states of Coppell 1007 IndeAendence 'Ibe baci�low prevmtion assembly detailod below has been tested and maintained as required bv TNRCC nsulations aad is certi5ed w be operating withia acceptable paramettrs. TYPE OF ASSENN�LY e Reduced Pr�ssure Priaciple e Pressurc Vacuimm Br�aker � Double Chak Valve ❑ A�ospher�Vacu�Breaker Manufactiaer �t►�Y1�S Siu � �� Model N�ber o�.0 U�`�J Locate�At {�30 �►w�x-Vr���'1.�. Serial N�ber ��l �01-� REDUCED PRESSURE PRINCIPLE ASSE�LY PRESSURE V 4CUUM BREAI�R ' Double Check Valve Ass�bly ' lst C3eck 2nd Cbeci: Relief Valve Air Inlet C6eck Va1ve Inidal?est DGCI ed. r Closed Tight Opened at Oponed at osid ' Ti,�ht �'~ Leal:ed ❑ nsid ___nsid RP-_psid � .�' Leal:ed � Did nct Opea o Leaked ❑ I, RtPairs � � I MatQials . Usod Test ARet DC-Closed Closod Tight o Opeaed at Opeaed at _�d ', Repair Tight ❑ _nsid osid j R.P sid ' The above is ceitified to be erue. ' c � G� � Ficm Name�-AFire&Domestic Tes'"ting CeRified Tes�t Firm Add�ess Po Box 7 9 5 4 8 Cert.Testa Na.BP 0 015 3 8 5 DQ�-���� Fort Worth Tx 76179 Gauge # 06070576 Date last acceu�acy tested 12/3/13 White-Customer's Copy Yellow -City Copy Pink-Tester's Copy