The URL can be used to link to this page

2015_0622 C�iECK ONE: IRRIGATION DOMESTIC FIRELINE BACI4'I�OW PREVENTION ASSEMBLY TES'T AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # , LOCATION OF SERVICE:�`�� ,� ��f LG{� ' L,Z�� The bacl�low prevmtion asscmbly detaile� below has beea tested and maintained as required by TNRCC regularions and is certified to be opera�ng withia acceptable paramtters. TYPE OF ASSEMBLY C Rcduced Pressure Priaciple e Pressvr�Vacu�Breaker � Double Chxk Valve o Atmosphere Vacuum Breaker Maaufact�aer ��'�� Siu U f I � Model Number Z 7� n �G� � Located At W� �-C � ��c_ � Scrial Ni�ber ��3� � REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�CUUM BREAI�R Double Check v alve Assembly lst Check 3.L, 2nd Cbecl:�. Relief Valve Air Inlet Checic Valve Iniaal Test DGClosed osed Ti;ht Opened at Opened at osid ��- Tighi Leal:ed ❑ vsid �sid J � RP-._,psid �;� p Did not Opea o L,eal:ed � �P� and Materials Used Test Aftet DC-Closed Closed Tight o Opeaod at Opened at _osid Repair Tight 0 �sid esid R.P sid The above is catified to be true. , � �/�/� . Firm Name � .c � J � Catifiad Testa �� t•C'2 � �. / Firm Address C7 S. �/�l�Z Cert. TesterNo.l�_l.�C�DC�`�6Z�te '`�� `1 yT�I� V�� (3auge #d b�� f� Date last accuracy tested f[ �S � �L.. White - Customer's Copy Yellow - City Copy Pink-Tester's Copy C�iECK ONE: IRRIGATION DOMESTIC FIRELINE BACT�I.OW PREVENTION ASSEMBLY TES?AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE:'Y��-�� S, IZ a��}/ L�'Z o �.�C� The bacl��low preveation asscmbly detaile� below has beea tested and maintained as required by TNRCC reguladons and is certified to be operating withia acceptable parameters. TYPE OF ASSEMBLY e Reduced Pressurc Principle � Pressure Vacu�Breaker � Double Check VaIve o Atm sphere Vacuum Breaker Manufactiaer �.��"S s� 3 �� Model Ivumber (7 E?7 �'� � Locaud At �'��' . � 'L' �Ll / s��,mmba �l�l s 3 � REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�CULTM BREAKER Double Check Valv�Assembly lst Check 2nd Checl: , � Relief Valve Air Inlet Check Valve Ini �al Test DGClosed ' losed Ti,Qht Opened at Opened at osid k� Ti�i Leal:ed o _asid nsid RP-_psid I,�;� p Did not Opea O Leaked � �P� and Materials Used Test ARer DC-Closed Closed Tight o ppene�at Opmed at __�sid Repair Tight o osid osid RP sid The above i�.. od to be true. - _ %"- �,� � �,�� ,� � l�`Z��-�.� Firm Name � �- 'k �� Certified Teste !.rp < I �� Firm Address Of� S: ��`�� l Cat Testa No. Date �2�� j�,��`�� 7 a� ��C��I6Z0 vauge � � b�27`3 0 llate last accuracy tested � �� G� White - Customer's Copy Yellow - City Copy Pink-Tester's Copy C�IECK ONE: % IRRIGATION DOMESTIC FIRELINE �/'� n BACKFLOW PREVENTION ASSEMBLY TES'T AND MAINTENANCE REPORT NAME OF PwS: CITY OF COPPELL PWS I.D. # LOCATIOIv'OF SERVICE: �� b �� S I�� Z D"� The bacl�low prevmtion asscmbly detailed below has baa tested and maintained as required by TNRCC rcgulanons aad is certified to be operating wiibin ac,ceptable paramtters. TYPE OF ASSEMBLY �c Reduced Pressure Principle e Pressure Vacu�Breaker Double Check Valve o A osphere Vacuum Bnaker ) / � � I Maaufaetzaer 1�(./l� ��"S Siu � Modei Iv umber O�� 1''� � Locaud At ��v � �� S= �L'� �z/ ( s«��N�� 's'6 b REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUiJM BREAI�R Double Check Valve Ass�bly lst Check . 2nd Checi: - 'ef Valve Air Inlet Check Valve Initial Test DGClosed losed Ti,ht Opeaed at Opened at osid n Tight Leal:ed o __Dsid _osid !"�`S s RP-_psid �;� ❑ Did aot Opea o Leal:ed � �P� and Materials Used Test ARet DC-Closed Closed Tight o Opeaod at Opeaod at nsid Repair Tight o �sid osid R.p sid The above is_cesdfied to be true. 4 / / Firm Name 1`�C ` � / /^'� Catifiod Testc T- LC�C� ��` G`I� L Firm Addr�ess t� [� %� , %L Cat Tester No. Date -22—�''. �'Zr'6t"��..'L°� �� ~ � o� � �j. Y�C�Oc-'�/�`�� Gauge # � � G��2�3 D llate last accuracy tested � ��S�� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy C�iECK ONE: IRRIGATION DOMESTIC FIRELINE � BACI�Z.OW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORZ' rr�ME OF Pws: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE: ' �' � �� ''G . �' � �'� The baclflow prcveation assembly detailed below has beea tested aad maintained as required bv TNRCC re�lauons aad is ctrtified to be operating withia acceptable paramcters. TYPE OF ASSEMBLY �C Reduced Pressure Principle � Pressure Vacui�Breakar Double Chcck Valve o Atmosphere Vacuum Breakerr Maaufacuaer ��-�S s� `� `� Model Number � �� C`1�'�- Locaud At ,��'��4" � � ��Zf� / s«��r��ba 1 ��D `�'l REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check Yalve Assembly ist Check2, : � 2nd Checl:� Relief Valve Air ldet Checic Valve Inival Test DC•Closed losed Ti,Qht Opened at Opened at esid Tight Leal:ed ❑ �sid osid RP-_psid �;� p Did not Open o Leal:ed � �P� and Materials Used Test After DC-Closed Closed Tight O Opeaed at Opeaed at �sid Repair Tight o osid osid R.P sid The above is catifiod to be true. � � iL� I��-� Firm Name <�'�<< I, /�� Catifiod Testa ,� � y ` / � 1 Firm Address ��C'�' ` �1 f�l L Cert Tester No. Date_ �-��Z��%`�� 13.�,pa� ��o d - Z2-t� cauge # �j 6 �'�Z`�`� � llate last accuracy tested � 'S `�� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy