Loading...
2014_1008 _ _ C�IECK ONE: IR.RIGATION DOMESTIC FIRELINE X BACI�LOW PREVENTIDN ASSEMBLY TEST AND MAINTENANCE REPORT N.4I�OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF S$RVICE:���ates of Coppell 1007 Independence 'Ibe baci�low pnvmtion assembly detailed below has bxn testcd aad maintaiaed as required by TNRCC ngiilations aad is cutified to be operating withia acceptable parameters. TYPE OF ASSEMBLY ❑ Reduced Prrssure Priaciple C Pressure Vacuimm Breaker � Double Check Valve D Amaosphere Vacuum Breaker Maaufact�er ��P S Siu � Y+ Modei lv�ber �j5� � Located At �� � �`-'l ', 5erial Nimmber ��0�� I ' REDUCED PRESSURE PRINC�LE ASSEMBLY PRESSURE V�CUiTM BREAI�R Double Check�alve Assembly lst C3eck 2nd Checl: Relief Valvt Air ldet Check Valve Inidal Test DGClose¢, losed Tight Opened at Opeacd at _osid Ti�t � l� Leal:edl � ❑ _nsid _,esid �� R.P-�psid !, Leal;ed ❑ Did not Opm o Leaiced ❑ '', �painC i aad � �� � � Macaials " Used Tcst ARet DC-Closed Clased Tight o Opened at Opmed at _Tsid ; Repair Tight ❑ �sid osid ; R.P id The above is cectifiod to be we. C� . F1fal N�II1C1-AFire&Domestic T�s�ng Cectified TestQ � girm pddnesa Po sox 7 9 5 4 8 Cert.Testa No.BP 0 015 3 8 5 D� � � Fort Worth Tx 76179 Gauge # 06070576 Date lest accuracy tested 12/3/13 White-Customer's Copy Yellow -City Copy Pink-TesteNs Copy