2015_1006 C�IECK ONE:
IRftIGATION DOMESTIC FIRELINE
BACI�LOW PREVENTION ASSEMBLY TEST AND MAINI'ENANCE REPORT
NAME OF PWS: CITY OF COPPELL
PWS I.D. #
LOCATION OF SERVICE: ��� �� ��"������� ���-�
The back�low prevmtion assembly detailed below has baa tested aad maiatained as required bv TNRCC
reQuladons aad is certified to be operating withia acr,eptable paramcters.
TYPE OF ASSEMBLY
C Reduced Pressure Priaciple � Pressure Vacuimm Breaker
,�- Double Check Valve o Atmosphere Vacuum Breaker
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Manufactiaer `� ��� > _ Siu
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Model Number �� ��� Locaud At , � � "�i
Serial N�ber �� � ' �`� �S�
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER
Double Check Valve Assembly
ist Checic 2nd Checi: Relief Valve Air Inlet Check Valve
Inidal Test DGClosed Closed Tight Opened at Opened at esid
Tight eal:ed ❑ Dsid osid
R.p-��sid `� G
�� p Did not Opea o L,eal:ed �
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and
Materials
Usod
Test After DC-Closed Closed Tight o Opeaed at Opeaod at _�s�d
Rapair Tight 0 �sid �sid
Rp sid
The above is catified to be we.
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�V�� � ` Cetifiod Testa ��`�
Fum Name � � � �� —
Firm Addras � � (. ��-c����Cert Te.tter No��,�``�� Date l��� �
(3auge # ��ti� �,� ��Z. � �
llate last accuracy tested
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
Ceil: 972-467-3918 �
Email: eddiegan1@sbcglobal.net
952 SARATOGA WAY
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 local 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 installation.
�,�PZE OF T
'.F,�.
..�� �'-�s
Sincerely ��'"•�.....,i*
EDWARD GANDARA ��3����.'��A�
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