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2014_1120 C�iECK ONE: IRRIGATION DOMESTIC FIRELINE ,, : BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT ;� , N. � � � � � � , AI�OF PVVS:� CITY OF' COPPELL - . , , t�. . . .. , ,. , . , � PWS I:D. # � � LOCATION OF SERVICE: ��`�I ��j�f��n 1�7Pi► � G�:A�7 r�.(�� The backflow prcveation asscmbly detailed below has bcea tested aad maintained as required by TNRCC reguladons aad is ceitified to be operating within acceptable paramcters. TYPE OF ASSEMBLY C Reduced Pressure Principle ❑ Pressure Vacu�Breaker 8� Double Chxk Valve o Atmosphere Vacuum Breal:er Maaufact�uer 1.1/.-�z 1�:� Siu ��� Modei Number 1'2�L��.�---- Located At t,1�f h'� !>�-� ,�`�� ✓c�t����' Serial Ni�ber /UU 3 �Q REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Check v alv�Assembly lst Check 2nd Chec�: Relief Valve Air Inlet Check Valve Inival Test DC-Closed Closed Ti;ht � Opeaed at Opeaed at nsid Tight � Leal:ed ❑ esid _osid RP-�sid �;� � �d � Did aot Opea o Leal:ed � RrPairs aad Mataials Used Test Aftet DC-Closed Closed Tight o ppeaed ai Opeaed at _�sid Repair Tight ❑ �esid _csid R.P sid The above is catifiod to be t�ve. r,, �"_ � Firm Name /�' ���✓ � pc'_� f JJ���✓w Certifiad T�sta Firm Address v �` � L -� .� Cdt Testa No. 1�4'�/'i��72a�Date_� " �` � �� ,-�.t�1��, '� . .�'2,z/3 Gauge # _�31�'11�� 7�. llate last accuracy tested �-� ;� •�U j � White- Customer's Copy Yellow - City Copy Pink-Tester's Copy C�IECK ONE: IRRIGATION DOMESTIC FIBELINE BACI�'LOW PREVENTION ASSEMBLY TES?AND MAIIVTENANC'�REPORT , . CITY DF' eOPP��� _ *; NAME 4F PWS: PWS'I:D.# , _ <'; LOCATION OF SERVICE: �t�")���r d���/,��r��e�� �_ The bacl�low prevmtion asscmbly detailed below has beea tasted and maintained as required by TNRCC reguladons aad is cerdfied to be operating within acceptable paramcters. TYPE OF ASSEMBLY C Reduced Pressure Principle C Pressure Vacu�Brealcer �.- a �,Doub�e�Check Val�¢ � . � ; �- ��� � Amio ae� �B . _ ��. � � ..� a . � �. e i , � , �B�II . �—: , . . . _:� ; , . . Maaufacturer �,1�c�.M�� Siu �/�'� � � �,�' l Model Iv�ber l�7�I Located At , ���-- i?�� i�-?'�,°.�t �;`,f�;`a�� Serial N�ber S-�- ��� _ REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�CUUM BREAI�R Double Check-Valvr AsSembly ` , . _ _ , , .: ' � ' �st�hec�C 2ad Checl: Relief Valve Air Inlet C1tck V�Iv�`` ;� Inival Test DC-Close� Closed Tight 0 Opeacd at Opened at �sid Tl�ht a Leal:ed o _�csid �sid R.P-_psid I,�;� o Did not Opea D Leal:ed � �P� aad Mataials _ Used � ' �� �', r : , , . , �,: - ,, �,, t� � . � , � ; ; _. Test After DC-Closed Closed Tight o Opeaed at Opeaod at _,,,nsid Repair Tight ❑ �nsid esid RP sid The above is cerafied to be true. � Firm Name ��,�✓ ��✓'�- �✓���4� Catified Tester ���r�5 /�:rn,� : ' i. � . �� �. , ,. � � ; q _ Firm Address v�- ' Cert. Testc No. ,��r� �1 �1��ate� � k �6 f ���� , ° cg�,� �f�a�7�_ ' + � �: .. llate ]ast accuracy tested _�j��- �f/�� White - Customer's Copy Yellow - City Copy Pink-Tester's Copy _ _ _ _. C�iBCK ONE: IRRIGATION DOMESTIC FIRELINE � � �BACI�LOW PREVENTION ASSEMBLY 3'ES?AND MAYNTENANCE�REPO�RT � � � � � NAN�OF PWS: , CITY OF COPPELL - ; . �, PWS I.D. # LOCATION OF SERVICE: ��J ,��✓�d f�t: �'�Ce.,sUv4". ���Dr�I ��. T3e bacl�low prevmtion assembly detailed below has baa tested aad mainta�n� � nq� bv TNRCC regulations and is certified w be operating within acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Principle C Pressurc Vacu�Breaker _�- , ID+. �, ��� . Y �� ,.; . �x_ �: A��sPh�lva��_�r4�r--.., _. . ,. � .. ..w, ,Doubl Check . A;.,_ ... ... _ _� _ Maaufactsaer 1,1�c� 5 Siu '��� Model Number 7 2�)C f:G�1� Located At �=�,;t�- ,;��r �� /v�'�'� s«;�t N,�ba ���D �1�� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�CUUM BREAI�R „ Double Check�alve Assembly { : . .lst Check 2nd Cbeci: Rdief Valve Air Inlet Checic Valve� �; Initial Tat DGClosed Closed Ti,Qht � Opeaed at Opeaed at �nsid '- Tight � Leal:ed o _�sid �osid RP- ���n Dsid �;� ❑ �� � Did not Opea o Leal:ed � �P� and Mat,erials Usad � , _ , . - �... . �. _,. .�� .. .... �.: J .:u:.,,.. � ,...-. . _ ' .�... _..�.�. _ t.�.., i.'� ._.w _ ... J �._i, .' �.... .,..�. .. ..��. �- ., _ ... '� ... ._. . . . ... Test After DC-Closed Closed Tight o Opeaed at Opeaed at �sid Repair Tight � �sid __osid RP sid The above is certified to be true. 1 ' Firm Name kr-�.� �.� ��v� ��>> �r.L��.�tr � Cerdfied Testa ��n�.:"� /��r i.,+�°�v� ` � � ��Fum Address l�� � � Cert. Taster No. ��, Date���- �1��' ��� � � � � �� � ,� 5, �� ���� , _ � _ g GB�e � Q,�������01�- � llate last accuracy tested � -�,-zQ�L� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy C�iECK ONE: IRRIGATION DOMESTIC FIRELINE BACI�ZOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT � .> ;:� , NAME OF PWS: CIT�OF COPPELL -� . . , . . . . . . . . . . . .. , . � � . � . . . � . ..:t. _ PWS I:D.# � LOCATION OF SERVICE: .j��'�� 1�Cl�'r r�y`�.�j� �C � The bacL-tlow prevmtion assembly detailod below has baa tesi�ed aad mainta�n� � nq�� bv TT�IRCC regulauons aad is cerdfied to be operating within acceptable paramcters. TYPE OF ASSEMBLY e Reduced Pressvre Principle C Pressurc Vacui�Breaker < � . �Double,�hcck Valve ;. , oK �. Ata�os�here V�cuug��re.a�:.__. - ,. _ ,, .. ._ t - -�._.,..�__. , .. ,, . . ._' �. ... p. . �_� .� . �_, .. . . . Maaufactsaer � ' ,� S� `�l � Model Iv�ber C`�l i `71'Y\ } Located At �- `' � `a`�� Scrial Nimmber ��l 7 r„ 7 REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R . Double Check Valve Assembly � lst C3eck ' 2nd CLecl: Relief Valve Air Inlet Check V�lve Inidal Test DGClosed Closed Ti,Pht o Open4d at Opened at nsid .` Tight �1: Leal:ed ❑ �nsid __nsid � RP-��sid Leal;od o '! � Did not Opea o L,eai:ed � �� � aad Mataials Us�d , ` _ • _ - - �_ .�_. .,. ,_ _ � � -- . ,.- . '� ; � . - . Test A.ft,et DGClosed Closed Tight o Opeaed at Opmed at _�sid Repair Tight � o :esid __..,nsid RP sid The above is certifiod to be true. ` :i _ Firni Name k:�.�",1�/ ,�4 �. /::;� ..c� Catified Teste .�;rN�.� /�i�c�,�.� ` girm AddRss ''�' : ! � ,�� �a, _ . Cat Testc No. ;t��f�3?�""Date �.� �j,� � ,fi � - ' llu�, � .�"",2� , . _', Gauge # �.3'la���ii7�- llate last accuracy tested _� -� �-�,��i{ White- Customer's Copy Yellow - City Copy Pink-Tester's Copy