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2014_0729 C�IECK ONE: IRRIGATION DOMESTIC FIftELINE �/ � . - .. ., . � . . � .. � � . � � . . � ' .�.p; . . . � .. . . . . � . . . � � . . . . � . . � . � .. . . . � ' ;� BACKFi.OW PREVENTI�N ASSENN[BLY TEST AND MAINI'ENANCE R�PORT " _ , ,. NAME OF PWS: CITY OF COPPELL ;, ,� PWS I.D. # LOCATION OF SERVICE: �c� t�. :;�-►.����, �.a,�e ����, '��,�:� R � 1 c The bacl�low prevention asscmbly decaile� below has beea tested aad mainYain� � nq� bv TNRCC reguladons aad is certified to be operating withia acceptable paramcters. , , � TY�-�OF ASSFMBLY _ � .. , _ ` e � Reduced Pressvre Principle e Pressurc Vacu�Breaker A � Double Check Valve o Atmosphere Vacuum Breaker Maaufacz�er �`��c..Q Sizc :��y " Modei Number �� � � `/ Locaud At �,�� ���1�- s�E ���r r��� ���..�1s�.�r .� Scrial N�bet f � REDUCED PRESSURE PRINCTPLE ASSEMBLY PRESSURE V.4CUIJM BREAI�R = ;,. Double Check V alve Assembly . � lst Check 2nd Checi: Relief Valve Air Inlet Check Valve Initial Test DGClosed Closed Ti,ght 0' Opened at Opeaed at osid � Ti�t /: � Leal:ed�, Z o �sid __osid RP-_psid �?��� Leal;ed o Did not Opea O Leaked o Repairs �M+r.� . � ..,.. �... �_i a ��..aKu� _i� ...: . S. �. A-... , ..._ � �'�� .,.. _- •,. _i 1 . h . ... .. ., .. . , i � ... rr .. �..., , � . , .. , ._.� . .., . .�. . . t., a - t .- � a .. r� � rt —.. p�. . a-- .,. . ; i � . . _ _ Mataials ? " Usod Test Aft,et DC-Closed Closed Tight o Opened at Opeaod at __�sid Rapair Tighi o �Dsid �sid R.P sid Tlze above is cextified to be we. -� Firm Name�-��� F�'� . .✓� �` �e /� � � r�'- �-/��'c.,.x r�� �, CCrttfied Teste[ ,.w r r - �;�,,,.? (,i I 3 t",r,�����taJi�. t'1�f ` Firm Addrr,ss i�;n�� caJ,,ca f-l;�T`� �?'th i t� Cat Tester No.�r'����'i.5���5� D� J /`� � . , � ; Gauge #�?� �;. �l S f ', llate last accuracy tested !, � / ` i White - Customer's Copy Yellow - City Copy Pink-Tester's Copy � „ - _ C�IECK QNE: IRRIGATION DOMESTIC FIRELINE ✓ ,� ,� BACK�Z.OW PREVENTIQN ASSEMBLY TEST AND 11�IAIIV�'ENANCE REPORT ,4 , � NAIv�OF PWS< CITY OF' COPPELL . � � � ? PWS I.D.# LOCATION OF SERVICE: �r�v ;�.�. .�",t ,�t�w �.�,��c= �`z:x '=-`_���;��..�I T"� � The bacl�low preveation asscmbly detailed below has been tested aad maiatained as required by TNRCC regulations aad is cerdfied to be operating within acceptable parameters. , ,,.�. , ; ..PTY���OF A3S�MBLY_ ;. .,.. ,, _ , . . �.; .. . r C � Reduced Pressure Principle ❑ Pre`ssure Vacuian Breaker ' � �' Double Check Valve o Atmosphere Vacuum Bnaker Maaufact�aer i�� �e-o Siu � �, Model Iv umber c'�'.�l� Locaud AL 1 N i/G�l+ 5l� �..�.r t..�� � Serial N�ber f REDUCED PRESSURE'PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R ; ` �; . , Douhie Check v alve As3embly , . '�' lst Check 2nd Checl: ReIief Valve Air Ialet Checic Valve . Initial Test DGClosed Closed Tight Opened at Opeaed at nsid Ti,ht � � � � Leal:ed� (� o osid _osid �, RP-_psid ` !#-�j Leal;ed O Did not Open o Leai►ed � �P� .... � ..: ,... ,.:..1 - ..._�a,,. ' Z .. � ,� ,., � F � .. � r..,. 1� ._.. .p. � i. . .,v .e• {-! ._ . . . .., . � ;�j� / j� .�! 1 �� . ^+�+�•' � � . � �8�I7� � �" � � fi , . , ITSCd Test Aftet DC-Closed Closed Tight a ppeaed at Opeaod at _s sid Repair Tight o nsid __nsid R,P sid The above is certified to be true. _T f � f ` Firm Name-,� �R� ���-�t� � �=��c����.� CettYfiied?estc k.�•�,c �� �,����-, !� j , � � � � �,t�� �.:tl. •.� �e�t;,i s"_` C�C"t7'i , —r � '! �„ _, . , , FirmAddress t�r��-� tz1�,� � �� , �'T`x �Jc�+�� CatTestcNoLa c:vt�.��l� �e � �`f ; (�auge # �f'� �. .� �,�--/ �__. Date last accuracy tested (�c J �? /� White- Customer's Copy Yellow - City Copy Pink-TesteNs Copy i „ _