2014_1110 C�IECH ONE:
II�RIf3ATION DOMESTIC FIRBLtNB �/
sAc�,ow��xriox�ss��.Y�s�r�rm r�►n�rrEx.wc��oKr
NAI�OF PWS: CITY OF COPPELL
Pws�.D.#
LOCAITON OF SERVICE: � • �
Tbe bac3d�law pr�vectioa assembly detailai below has lx;ea tested ar�d maintai�d as required bs► TNRCC
regnlatic�s�nd i�ceitifiod to be op�ting withia acceptable parameters.
TYPE OF ASSEMBLY .
C Reduc�ed Pr�ssure Principle e Pressuc+e Vacu�Bt+eaia�r �
/�0� Double Check Valve o Amlospl�re Vacuum Br�alc�r
Maaufact�acr LV/ItC f n13 Siu Q��
Modei lvumba .� 5�0 Q S`�' �� I.ucaced At /� (1(� Ghr h�� //�.u�'
Scrial N�ba I S �,l �
REDUCED PRESSURE PRINC'IPLE ASSEMBLY PRESSURE VACUUM BREAI�R
Donbie C'l�ecic V alv�e Asxmbly ,
i�c-�� 3,r� �a c�x3.�' ��� �r� a�v�
Imnal Test DC-Closed losed Ti$ht Opee�eed at Opeaed at �d
Tight . L,ealxd o nsid �d
/f�/v�l'� RP-_Fsid
k� o Dfd not Opm O L�ealc�dd O
��
a�
Materisls
Uaed
Test ARv DC-Closed Clased Tig�t o Opcud at Opcaed at _paid
Repair Tight o oaid __,nsid
RP
'Tbe above is cxstifiai w be true.
Firm Name �����' Cati�iod Testa ,/)�e h h ��l. ��'✓�
Finm Addcesa�� �i-�`'�- "7 �j '� Cat Testc No�,�Pr��jS�Date /' /d J/�
Gur�f. � ?S/(a8
Gaug+e # � `� A 1 b�8�
Date last accuracy tested �i-/�-/�
White-Custame.r's Capy Yellow -City Copy PTink-Tester's Copy
C�IECK ONE:
IRRIGATiON DOMB3TIG FI$ELINB V
BACI�'LOW PREYENTION ASSEMBLY TF.S!'AND MAINTENANCE REPOR?
NAI�OF PWS: CITY OF COPPELL
PWS I.D.#
LOCATION OF SERVICE: � A�i�
The baci�low preve�on asscmbly detailed belaw has bxn tate� aad mai�ataiaed as requi�d bp TNRCC
re�ila�uu�ss ae�d is certiSod to be operatiag withia acceptabie parameocts.
1'YPE OF ASSEMHLY .
C Re.duc�cd Pressvrc Piinciple e Priessuc�e Vactnmi Bnaker
� Double Check Valve o Asmosphere Vacuimm Brealoer
Maaufactiaer L��wy- Siu ��
Mod�ellvt�ba � �. Z I.ocatedAt 1� v�( � I�G�
s�x�� 3��o � �� x�.�
REDUCED PRESSURE PRINC'IPLE ASSEMBLY PRESSURE VACUUM BREAKER
Double Checic V alve Asxmbl' W d
lst Check /. �� 2nd CLe�k ��a Rdief valve Air ldet Chedc Vah►e
Initial7est DC-Closod Closed Tight Ope�aai az Opeaed at �id
Tight Lealrod o �d �d
��/� �� RP- Dsid
� ❑ Did noc Opea a L e a k e d o
�P�
a�d
Materials
Usod
Test AR�t DC-Closed Closod Tight o Opaaed at Opcnod at _psid
Repair Ti�t o _fls� __nsid
RP
'Ibe above is catifiai t�be trae.
Fitm Name A��.�•� �ue �i�05 CatiSod Tester �rt>'l-t�4� C,�c>��.��
Fnm Add�s � � � Cert.Textc No. �P� ��.�7nee� -/v-/��
�, T� �sf��
Ga� # p 7p b f �
Date last accuracy tested � - /(� � ��
White-Custom�r's Copy Yellow -City Copy Pink-Tester's Copy
C�iECK ONEz
IRRIGATION v DOME3TIC FIRBLINB
BACIC�3.OW PREVENTION ASSEMBLY TES'f AND MAIIVTENANt�REPOR?
NAME OF PWS: CITY OF C4PPELL
PWS I.D.#
LOCATION OF SERVICE: ��� � � � � 0�-�`
The bac�low prevmtion assembly detaiIod below has bem tesoed aad mai� as requued by TNRCC
regulada�s and is cem,ficd to be operatiag withia acceprca�ie p�rs.
TYPE OF ASSEMBLY .
❑ Roduced Pressure Priaciple e Pness�u�e Vactnrm Breaber
I,ef Double Check Valve D AtmosphGre Vacu�B�1n�
Maaufacturer �E',1g� Siu � r�
Model Ivumber D v�U Lccated AL �� � �o� �„���^*� ��
Serial N�ber � ���5 2 �
REDUCED PRESSURE PRINCII'LE ASSEMBLY PRESSURE V:�CU[JM BREA�I�ER
Donbk Check V alve Asaembly ,
1 st Check /, � 2ad Clrcc]c ,h Rdie;f�alve Air Iakt C7ieck Vayve
lnival Test DC-Closed Closad Tight C)peaed at Opened at �d
Ti�t Leal�d o osid __osid
���°`/� �-�a
� o Did�t Opea O Leakod o
��
and
Materials
Used
Test Ai?er DC-Ck�d Closed Tigbt o Opmed at Ope�aod at �sid
R�pair Tight ❑ Dsid _osid
RP
'Tbe above is certified to be true.
Fiim N�e �c�.._ �.*-�_ ��vS Catifiod Testc /'S.�arn��� ��
Firm a" v Bv� �cl 7 Cert.Teatc No. $�v,�.��s/hDate " f���`T�
..-
�, �1�- �S/��
Gauge # 6 7 r��'t��.d��
Date last accuracy tested E�- /v� /t,1
White- Custoiner's Copy Yellow -City Copy Pidc-T�ter'�s Capy
C�IECH ONB:
IRRIGATION DOMBSTIC � FIRBLINB
sa�ow pxEVEr�rrlorr�ss��.Y�sr�xn�n�rr�cE xEroRr
NAI�OF PWS: CITY OF COPPELL
PWS I.D. #
LOCATION QF SERVICE: �� /�• � �u-�
The backAow preveatiam assembly detailod be�ow has been cesaod a�d maiataiaed as required by TNRCC
reguiariaas�is c�tafied to be opaatmg withis accxptable para�eders.
TYPE OF ASSENIDLY .
c Reduxd Pressurc Principle c Pnessure Va�w�Bre�iOer �
� Doublc Chcck Valve D Atmaaphere Vacu�aa Breaker
Maanf'actia�cr G�Q� Siu 2��
Modellv�ber Otl�'1�J Lc�cacr�ci At � � @ /�-�-�.
Scrial N�mtber �.��a 7�
REDUCED FRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM R.�s�'R
Doubk Chedc V�ive A�aembly „
lat Cheek /, a 2nd Cbecic�.!•' g,�V�ve Air ldet C�edc Vahre
Imn$1 Test DC-Closed Clc�sed Ti�ht Opeaed at Opeaed at __,asid
Tight t.d Lea�xd ❑ �d �d
�/�/0�/ Rp_�sid
� ❑ D i d�t O p e n D L e a l�e d o
��
an�d
Mate,rials
Uscd
Tesc ARer DC-Clc�sed Clos�d Tigbt o Openmd at Opmod ac _psid
Repair Tight ❑ �sid _nsid
RP
'I�e above is cx�ti5cd tA be true.
F'nm Name �c��N,--�+�. C"YnS CatiSad Tatc �.�.-�e�v ��
F'nm Add�ess P� �� ��7 Cat Testc No. g Pvr�LG/S�Dat,e - /�� ' �`�"
G��, Ti�. ?5/�d�
cauge # o�a 9 v Ll-��
Date last eccuracy tested � ' /v' /�
White-CustomeCs Copy Yellow -CitY �PY Pbik-Teste�'s CoPY