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2015_0211 (2) C�IECK UNE: IRRIGATION DOMESTIC FIRELINE � BACIQ�7.OW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: ���' W��•��r.�� �r The bacl�low prevmtion asscmbly decailed below has bxa tested aad maintained as required by TNRCC reguladons and is cerdfied w be operating withia acceptable paramcters. TYPE OF ASSEMBLY ❑ Reduced Pressure Principle � Pmsure Vacuimm Breaker � Doubl�Check Valve ❑ Atmosphere Vacuum Breaker ._ . _�_�_ .�_��__;�_.a=�. _ _. � ��,:-- _ _ ., __-�- _ . >. . _ �� �.. .. �.__�,,,.�._.�:: __� _�__.._:__,;,_.._� __�>..- ____, . _.__ _ __ _- Maaufactiaer ��P/ �ia_� �IZC �/e, Model Ivt�ber � E�� Located At � L (c�i+�f, � � �a�r c �;�5 Scrial N�ber �t �'� l REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER �r Double Check Valve Assembly ,'�r ; lst Checic 2nd Cbecl: Relief Valve Air Inlet Checic Valve Inival Test DGClosed Closed Ti,�ht t� Opened at Opened at esid �c 5 s Tight ld Leal:ed o �nsid _�nsid -� R.P- � `�osid � � Leal:ed o Did not Opea o Leal:ed o RePairs and Mataials Usod _ ,. _ . . ___ _ ._ _ . _ __ ,_. _ _ Test Aftet DC-Closed Closod Tight o pp��� pp�a�� �sid Repair Tight o _,nsid osid RP sid �� Tbe above is cetifiod to be true. �!-� S Firm Name la c T-�o r F- �� Cec[ifiod Testet � t,JC.��� W e •�,��• Firm Address �c� (�o X 7 5� Cert. Teste No. �c� 5 y d 5" Date I /� l! � (�vc�Cr.cCv2 T�` �y �b� �� � � � �� . . . . . . . � . "i Gauge # C.?3c.kG���y '1 Date last accuracy tested 3�1`! � � � �;� � ; White- Customer's Copy Yellow - City Copy ` Pink-Tester's Copy � __ C�iECK ONE: ' A IRRIGATION DOMESTIC FIRELINE � '� BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REppRT �. � NAME OF PWS: CITY OF COPPELL � � ; � PWS I.D.# �i �,� � LOCATIOIv'OF SERVICE: �I � ln�r c � a i r� �� A , -� The back-flow preveation assembly detailed below has beea ttsted aad ma�n ain� � nQ� �, �CC reguladons and is cercified to be operating withia acceptable paramcters. TYPE OF ASSEMBLY C Reduced Pressure Principle e Pressurc Vacu�Breaker _._. .__ _._ .�7__ o s Amiosphere Vacuum Breaker - _,,l�---_�-Z�y�R_-�- �" -�� �=�`� - � -- _�. �s r- s;°;_ � —-� . _LJ _. ,Y ::__-�• . „ � ��._��___ x �_ ._. _ ,._ - Maaufacziaer 1-� ��� `.l Siu , Model Number � G � � Located At S G� CG�,� -, v (� E��r c ����.5 Sezial N�ber U ov � C�9U REDUCED PRESSURE PRINCTPLE ASSEMBLY PRESSURE VACUUM BREAKER Doubie Check Valve Assembly lst Check 2nd Checl: Relief Valve Air Inlet Check Valve Initial Test DGClosed Closed Ti;ht � Opeaed at Opened at �sid p5 Tight � Leal:ed ❑ _nsid _�sid � y �_ � S�a �� Leal:ed 0 Did not Opea o I,ea�;ed � RtPairs and Mataials -_ . __ _ Usod ,_ _ � . : ;.. � ,_� _ _.__ ._. � f ,�` - - .� � . _�, �� _- ��.._' -y � . =R �,:. _-x�� � ;. �CSL ARC� �-C10SGd C�OSCd !l�lt O ��Cd 3t �CIIOd� _ ��Sl� , - _ Repair Tight � _osid _,osid R.P sid • The above is certifiod to be true. �J�' � �a Ficm Name �C r���.. F' -� Certifiod Testes I_ `, GJe.�.�c. W r� ►•� t- Firm Address Pc� ��X 7 S� Cat Testc No. vc�c+ 5�lJ 7 Date 1 �o � � We,���, �ee. . `�-� �7l6 '� V8� � ��v�'��)!E3 ; llate last accuracy tested 3//'/ White - Customer's Copy Yellow - City Copy Pink-Tester's Copy � . C�IECK ONE: LRRIGATION DOMESTIC FIRELINE ?� BACI�'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAI�OF PwS: CITY OF COPPELL �� PWS I.D. # . ; �.: LOCATION OF SERVICE: �� � 1�J r� ���f r � / �: The bacicflow preveatioa as�embly detailed below has beea tested aad maintained as required bv TNRCC re�euladons and is certified to be operating within acceptable paramtters. TYPE OF ASSEMBLY C Reduced Pressure Priaciplc ❑ Pressurc Vacu�Breaker . .� 4 DQu�e Check Valv� . � o � Atmosphere V�cuum Breal.er__, ,�,� � _,R. . -: __ __ . __. - -_ _ �- - - - ��-�---- ..w `,�',. ,. -�_ ; - ,,� _ �._.__#,__-.�-_ � - , '''_ . , r Manufact�aer E� ��5��1 g� 3l�l Modei Number � r �C Locaud At .S. W (c���^ -� � (' �'��r� 0��� Scrial N�ber c�r K�w n REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACWM BREAI�R Double Check Valve Assembly lst Check 2nd Cbeci: ' Relief Valve Air Inl�t Check Valve '� Ininal Test DC-Closed Closed Tight �ffi Opened at Opeaed at nsid Ti�t 4� Leal:ed ❑ _osid _osid ��'�5 RP-1�psid �,� Leal:ed ❑ Did not Opea o I,eaiced O RePairs and � � ��`� Materials Used . . ; .: _ = _ � � , -. � _._ _�.�.� -�-- - ,. . . , _ - - - -- T_ _ �r- . _ , Test Aft�er DC-Closed� � Closed Iight �] ppme�at Opmed at _nsid � Repair TighL ❑ �flsid osid R.P sid The above is catified to be we. /T 5 Firm Na�u /1�rr��, �'• �- Certified Testa �I.J c.��c u�J r.,.,..� �, Firm Address ac.>� ��' `7� 7 Cert. Tester No. a�o �`'��'" � Date ��01' W¢��.�,<<.�t �.r' �� ��S Gauge # C7 3 ov JJ� � ;; � Date iast accuracy tested 31 i�/ ^� fa ,� White - Customer's Copy Yellow - City Copy Pink-Tester's Copy C�IECH ONE: � � IRRIGATION DOMESTIC FIRELINE � BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE: �:i� � l�U tc J.�i r. (, � The bacl�low prevmtion assembly detailed below has baa tested aad ma�nta�n� � nq�� bv TN'RCC re,��ulanons and is certi5ed to be operating withia acceptable paramctets. TYPE OF ASSEMBLY c Rcduced Pressure Principle e Pressurc Vacui�Brealcer �_ _ , . . ,., - - _ o ___ AtmQsphere Vacuum B.rcal:er ., _ _._ i�cpA . Maaufacnaer l-� �,�--.� Siu � Model Number � C !I Located At S� � �Q r r��, v �" ���r� �1��� , Serial N�ber G�a c� �6 S � REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER Double Check v alve Assembly lst Check 2nd Checl: Relief Valve Air Inlet Check Valve Tnival Test DC-Closed Closed Ti�ht � Opened at Opened at nsid �`� ,�g Tight � Leal:ed o _�nsid _�sid RP- 3-� Dsid 3. v �;� ❑ Did not Opea o Leal►ed ❑ RePairs aad Mataials Usod __ - _ _ .__. , . Test ARer DC-Closed Closod Tight o Opeaed at. Opaaod at . .. ��id ~�# �pa�r Tight O �osid� nsid � RP sid � The above is certified to be true. 4�- 5 Fiim Name��7�o v� F�'� Ceciifiod Tester 1 �t�c-r-�z W�„✓► �'f , F�p�$ P� i�o,: 7 q 7 Cert Testc Nn. c��v 9 wJ 7 Date 3 I 1� l- � � �c*�c.v.�c�- +c ?�r �a`IGS ; ;. Gaug�e # �3vv r3J�8 .. '��� f; , llate last accuracy tested 3/+�/ � White- Customer's Copy Yellow -City Copy Pink-Tester's Copy C�IECK ONE: IR.RIGATION DOMESTIC �4 FIRELINE BACI�LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORZ' NAME 4F PWS: ' CITY;OF COPPELL PWS I.D. # : LOCATION OF SERVICE: ��7 w�A,��.� �� (�r The bacl�low preveation asscmbly detailed below has beea tesied aad ma�n air� � nq� �, '�CC rcgulations aad is certified to be operating within acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressure Principle C Pressure Vacu�Breaker . _ _. _ ,,,,?�z ._-�_ Doui�1�C�xk Yals►tq :�,,� _ _ � .� �mn�o�phare�Vacu�m Breaker � _ _ _ _ �__ _ , � . _. � �. �^ � � ,, � ,� ,f , � k� � E � Maaufactiaer 4r��, T, `� Siu � Model Number U c:� w� i I,ocated At � S�c c v� 5 i r��. ; Scrial Iv�ber ��' I 6 3 REDUCED PRESSURE PRINCIPLE ASSEMBLY �RESSURE VACUUM BREAI�R Double Check v alve Assembly � � ' 1st Check 2nd Checl: Relief Valve Air Inlet Check Valve ` Inidal Test DGClosed Closed Tight ,� Opeaed at Opeaod at csid Ti�t �D Leal:ed ❑ _osid _osid ��' S� RP-�� Dsid �:,� �J L,eai;od ❑ Did not Open o 1,eai:ed D � RePairs aad " Materials sed_ . ,. u, �.. � � � � ,E . � .,.� ., . �_, . _ ., . . . ,� ._ . . .� _r _.- _ _... , .- - _.. �._..v. , k� ..., _ . . + _. _ ,_. . . j�, .' -- � . - :�'_- - - -. Test After DC-Closed� � Closed'�ight o` ppenod at +�med at _�sid Repair Tighi a �sid _._,osid R.P sid The above is cati6ed to be true. �1 Y� Firm Name /�� T��� ���` Certifiad Testc 1 �w�_,��- W C���, Firm Address �� n x ° � Cat Tester No. U c�9`�J� Date a I i I r ` , C)rLhCLvc 7'Y 7 � �G� G8� � U 3v��� r� llate last accuracy tested �/!�1 White- Customer's Copy Yellow - City Copy Pink-Tester's Copy C�IECK ONE: IRRIGATION�_ DOMESTIC FIRELINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PwS: CITY OF CaPPELL � .;. PWS I.D.# LOCATION OF SERVICE: a 17 I.J �c�n��•i �r � '� Tbe bacl�low preventioa asscmbly detaile� below has beea tested aad main ain� � nq� bv TNRCC regulations and is certified to bc operating withia acceptable paramcters. TYPE OF ASSEMBLY C Rcduced Pressure Principle C Pressurc Vacu�Breaker . _ .,�� _�,� �au�.Ch�eckV�lY� . �„ , . � �, . .A�q�spherG�Vacu�ra$r��_y :,-� :-� Maaufact�aer � t 'o�o Siu � Model Number �,o .� `� Locatod At �-1 S ��t a�► 5 t,� t � " Serial Nimmber ! 7 ��oc� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRES$il'RE V�CUUM BREAI�R Doubie Check Valve Assembly � ist Check 2nd C3ecl: Relief�alve Air Inlet Check Valve Initial Test DGClosed Closed Tight �fJ Opeaed at Opened at _nsid �j�, •,,`� Ti�t rJ C!� Leal:ed ❑ ��sid nsid RP- /��> Dsid /.v LeaI:ed o Did not Opea o L,eal:ed o aad� �` Mataials ,. .. . ��.�,.. -.� '.rvre .J� .. � J �n. ,. � i . ..�. t .. . � ..r. . ..- .. .. ...: � . ..�'.. �.. . ... . .. . .. . .. .. ., . . , .... �.. . . .. .... „� "_._ _. . _ �_ a� .- t_ _ _ _ ., : . �' ._. s.---" { - - �. , gh � ppened at O�ea�at -.,nSid Test Ai3er DGClosed Closod'F�i t �- - � Repair Tight � osid ___osid R.P sid The above is ce:tified to be true. y Y �, Firm Name�1��,�� F�-� Certifiod Testa t-��k� ��c W c � on>� Firm Address � �� ``► Cert. Tester No. Ua o 9�1��` Date t ! i I �� c,�c�.��k � � � 7�/�� Gauge #k U 3 0° �J�� �F llate last accuracy tested 31��! � R} White - Customer's Copy Yellow - City Copy Pink-Tester's Copy _ . _ _