2014_1006 ___ _
____
C�IECK �NE:
IRRIGATION DOMESTIC gIRg�g X
BACIQ�'I.OW PREVENTION ASSEMBLY TEST AND MATNTENANCE REPOR?
rr�OF Pws: CITY OF COPPELL
PWS I.D.#
LOCATION OFSERVICE: Estates of Coppell 1007 Independence
The baci��]ow prevention assembly detailed beiow has beca tested aad maintaiaod as required bv TNRCC
re�t�latioas and is cerdfied to be operating withia acceptable parameters.
TYPE OF ASSEMBLY
e Rtduced Press�e Priaciple e Pressw�e Vacu�Breaker
� Double Check Valve O Amaosphere Vacuum Breaker
Maaufacnaer IQVY1�,.5 Siu I r�
Model lvumber o`W�J, Locaud At �6 7r�i ��
s«;�x�v� �5��P
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VAC[TUM BREAI�R
Double Check�alve Ass�bly '
lst C3eck 2ad Cbeci: Rdiet Valve Air ldet Check Va1ve '
Inival Test DC-Closed Closod Tight Opened at Opeaed at �sid '
Tight �'�' Leaked 7,v o _nsid _nsid
R.P-_psid
Leal;ed o Did not Open o Lesl:ed ❑ li
and� � �
Mataials '
' Uud
Test After DC-Closed Closod Tight o Opeaed ac Opened at _�d ;
Repait Tight o �Dsid osid '
RP sid
The above is ccrtified to be true.
, �
F'itIIf AT�C1-AFire&Domestic mes'ti ng Ce[�ified T� ' '
F�p�PO Box 7 9 5 4 8 Cert Testa No.BP 0 015 3 8 5 Date�`�
Fort Worth Tx 76179
Gauge # 06070576
Date Iast accuracy tested 12/3/13
White-Customer's Copy Yellow -City Copy Pink-Tester's Copy