2014_1008 __
C�IECK ONB:
IRRIGATION DO1f�ESTIC FIRELINE X
BACI4'LOW PREVENTI�N ASSEMBLY TFST AND MAINTENANCE REPORr
NAAitE OF PWS: CITY OF COPPELL
PWS I.D.#
LOCATIONOFSERVICE: Estates of Coppell 1007 Indet�endence
The bacl�low prevention assembly detailed beiow has baa tesfed and ma�nta+n� � �q� � �CC
re_sulanons and is cerdfied to be operating withia acccptable parameter5.
TYPE OF ASSENNIBLY
e Rtduced Pressure Priaciple ❑ Pressure Vacuimm Breaker
� Double Check Valve ❑ Amnosphae Vacu�Breaka
Manufactiazr ��S Siu � "
Modei Iv�ber c�Ut�DU Located At a''�.3 � '-�""_' � '
Serial N�ber �� y S ,
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACLIUM BREAi�R '
Double Checic V9lve Ass�bly I
lst C3eck 2nd Checl: Relief Valve Air Inlet Check Valve '
Iaidal Test DC-Closqd Closcd Tight Openod at Oponed at _nsid
Tight I f� LeaL:cd o nsid _nsid � I�I
R.P-_psid �
L.eal:ed o �� Did not Open o Leal:ed ❑ I,
RePaus y
aad I
Mataials
' Used
Test ARer DC-Closed Closed Tight o Opeae�at Opeaod at _Tsid
Repair Tight ❑ _nsid `osid ;
RP id
The above is cerdfied to be trut.
i
FifID N�IIiCl-AFire&Domestic TeG't ing CCRt�e�TCSiG I
g�p�s P o s o x 7 9 5 4 8 Cert Testa No.BP o o i s 3 a s � Date �
Fort Worth Tx 76179
Gauge # 06070576
Date lest accuracy tested 12/3/13
White-Customer's Copy Yellow -City Copy Pink-Tester's Copy