2015_0729 C�iECK ONE:
IRRIGATION DOMESTIC FIRELINE
BACKFLOW PREVENTION ASSEMBLY TES?AND MAINTENANCE REPORT
NAME OF PwS: CITY OF COPPELL
PWS I.D. #
LOCATTON OF SERVICE: _��� ���l� K/U�S�S
The bacl�low preveation assembly detaile� below has beea tested aad ma�ntain� � nq�� �y �TRCC
regulations aad is certified to be operating within accrptable parameters.
TYPE OF ASSEMBLY
C /Reduced Pressure Principle e Pressurc Vacu�Breakcr
.e� Double Chxk Valve o Aunosphere Vacuum Breaker
Maaufactsaer _ � Siu �T�1
Model Number � � Locaud At ��d�— �,
s«1�x�� � � �'03l'�
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�CUtJM BREAI�R
Double Check Valve Assembly
lst Check 2nd Checi: Relief Valve Air Inlet Check Valve
Inival Test DGClosed Cl sed Ti,�ht ed at Opened at esid
Ti�i eal:ed o _�sid _nsid
RP-�sid �
�� ❑ � Did not Opea ❑ Leal:ed �
�P�
and
Materials
Used
Test After DC-Closed Closed Tight o Opeaed at Opmed at __osid
Repair Tight 0 flsid _,_nsid
RP sid
The above is cerdfied to be true.
,�D � —��2 �a T� � ���� �r9
Fum Name �/4 r42 C
Firm Address 3 qO/ GLi�7?�.c� D�Cert. TGster No.���✓SZ Date ��ZGI�I 5/
Gauge # COti�1Z�4-�� �/L 6 5�
llate last accuracy tested /�r Z ��! �
White- Customer's Copy Yellow - City Copy Pink-Tester's Copy
GANDARA IRRIGATION INC.
3901 Clifton Dr. Richardson TX 75082
Office: 972-671-3776
Fax: 972-664-9158
Cell: 972-467-3918
Emaii: eddiegan1@sbcglobal.net
819 PREAKNESS
BELMONT LANDING
COPPELL TX
To Whom it May Concern;
An irrigation system was installed at the property described above. In accordance with
the city of Coppell inspection requirements, we are providing the following information.
This irrigation systemhas been installedin accordance with all applicable
State and tocal laws,ordinances,rules,regulations and orders.
I have tested the system and determined that it has been installed according
to the irrigation plan and is properly adjusted for the most efficient
application of water at this time.
1 year warranty from the day of instailation.
Sincerely
EDWARD GANDARA
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