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2015_0121 . . - . . , . . . � xF� x C�IECK ONE: � IR1tIGATION DOMESTIC �l FIRELINE ; ,� , �BACI�'LOW PREVENTIQN ASSEMBL�rEST'AND M.�,INT�N�NC�REPbRT" , , ; � � . ,.: - CITY OF COPPE�L � NAME OF PWS: >�. _ . � PWS I.D. # LOCATION OF SERVICE: I � � � k . .� a n� � t-�, k e The bacl.�flow prevmtion assembly detailed below has beea tested aad maintaincd as required b�, TNRCC regulauons aad is certified to be operating within acceptable parameters. . , -TYPE OF ASSEMBL� e Reduced Pressvre Priaciple e Pressure Vacu�Breaker � Double Chxk Valve o Atmosphere Vacuum Breaker Maaufactiaer �"�d� S Siu � , � � � Model Number C�0 7 ,.+�) ' (,Y�` Located At �o r�. /✓1 e_��r- ��,Y Scrial Nimmber �� � �� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Cbeck Valve Assembly lst Check ?ad Checl: Reiief Valve Air Inlet Check Vaive Ininal Test DGClosed Closed Ti;ht ❑ Opened at Opened at ,esid Tight O Leal:ed o nsid _�sid � ��� � RP-_psid � Leal:ed � Did not Opea � L,eal:ed o �� fi��.a����. �� c����h a�, Matesials Usod Test AR,er DGClosed Closod Tight Opened at Opeaed at �sid air Tighi _�sid __�osid 3 RP sid The above is cerdfiod to be we. Firm Name �;u er s o �: cd� �-.'�e Catifiod Testa Q �t��� I'e�s Firm Address S Cert. Testv No. (3 P o b I 5�0 9 Date � 3 a /S �a r t_ �,Jo r t1t,?X �� �► � Gauge # __� �--a S n► �o Date last accuracy tested ,5 � Q White- Customer's Copy Yellow - City Copy Pink-Tester's Copy C�IBCK ONE: IRRIGATION� DOMESTIC FIRELINE . BACI�LOW PREVENTION ASSEMBLY TES?AND MAINTENANCE REPORT ; NAIv�OF PWS: CITY OF COPPELL � PWS I:D. # LOCATION OF SERVICE: �N I O [ � � � The bacl�low prevmtion assembly detailed below has beea tested aad maintain� � nq� �, '�CC regulations aad is cerdfied w be operating within acceptable parameters. ... � 'TYPE OF ASSEMBL�` 'C Reduced Pr�ssiirc P�4aciple _. ' � �Pi�essur�Vacu�mm Brelaker , . 7� Double Check Valve ❑ Am�osphere Vacuum Breaker . Manufact�er c b�„ S iu �-. O � Model N�ber �S b Located At ��ce.. S c�r�.�� P �o�C s«��N�ba � �3 0 0 � i REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check Valve Assembly 1st Check 2nd Checl: Relief Valve Air Irilet Check Valye Inival Test DGClosed Closed Ti;ht Opened at Opened at nsid Tight Leal:ed ❑ �sid _esid P�,s� �- �� S�a � Leal:ea ❑ ' s Dia noc opea o Lesi:ed o RtPairs and _ hlate�ials .- . - ; _ �. _ . ,_._ .__ _�.z . � _. _ ., , . .- ... _. ,� k ;. , ... . _ ;� , ___ ; � ._ . , , _ T . • . Used � , Test Aft,er DC-Closed Closed Tight o Opened at Opeaod at �sid Repair Tight ❑ _�sid osid RP sid T'he above is cerdfied to be true. Firm Name �%�r er s;�';e„� ��r t Ce[tifiod TesLer �er e)� '�c1�@r� , Firm Address -'y � �a W Cert. Tester No. �o� 1 S�'a 9 Date 3 6 /� �� W�r , X ��l�� (Gauge # 1�. o S� 13 0 llate last accuracy tested � �o White- Customer's Copy Yellow - City Copy Pink-Tester's Copy ,; C�iECK ONE: IRRIGATION DOMESTIC FIRELINE _ ti: BACI�'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT ' NAI�OF PWS: CITY OF' COPPELL F � PWS I.D.# LOCATION OF SERVICE: 1� J O i= , S��h��_� � k� � The bacl�low preveation assembly detailed below has been iesied aad ma�n air� � nq� �, �CC regulauons and is cerdfied to be operating within acr,eptable paramcta�s. ,. �TYPE OF ASSF,�v�L� . , ,, - , _ � .�: � .. . . ' C / Reduced P�essure Pr�nciple ' ' � _ �Pressur�Vacu�Bre�ker �� Double Chcck Valve o Amiosphere Vacuum Breaker i � Manufactiaer �a. �S Siu 2 , n Modei Number o� �7 M 1 QT Located At ���.�-�. n'►e.}`�- �a X Serial Nimmber � � � ) (, s. REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R � Doubie Check v alve Assembly ' lst C3eck �nd Checl: Rdief Valve Air Inlet Check Va1ve Initial Test DGClosed Closed Tight �' Opeaed at Opened at �sid Tight Leal:ed ❑ nsid _osid �o.5� R.P- z�sid Leaked ❑ 2 . � Did not Opea o Leal:ed o Repairs aad - A�! ' � .�. �� ��� � � . � r _ � . �,__� : _ ; � •-� .F-�.� � _ _ .. _ � �._ - � . K =-�m - . - ;��-� Usod Test AR�er DC-Closed Closed Tight a pp��at ppeaed at �sid Regair Tight O osid __osid RP sid The above is cvafied to be true. Firm Name �:v er S;�,'e.�. ���� Cectified Tester � er� jC �e f e/�S , Firm Address �`1 Cert. Tester No. f�P o b 1 SS�9 Dau U` ` F�.�- Wo�ti,,.�' 7�,��-� c�suge # 1 2 o So 13 0 ' llate last accuracy tested S 1 � ' White - Customer's Copy Yellow - City Copy Pink-Tester's Copy ;� C�iECK ONE: IRRIGATION DOMESTIC FIRELINE ✓ � :�. BACK�'LUW PREVENTTON AS5EMBLY TES?AND MAiINTENANCE REPORT , y NAME OF PWS: CITY OF COPPELL :� PWS I.D.# LOCATION OF SERVICE: I�j U � . ��r� , L�.�''P J'��� The bacl�low preveation asscmbly detailed below has beea tested aad maintained as required by TNRCC regulauons and is cerdfied to be operating within acceptable parameters. . ,, � ; � , � . '__ �TYPE O�F ASSF�TvlBL� .. �. , u .. � � C Reduced Piessure Pr�nciple � ' � �Pressvre Vacuimm�$ 'r��ker ' ,� _ � Double Check VaIvc o Am�osphere Vacuum Breaker �. 3�y `� Manufactiaer W �< Siu Model Iv�ber Q� � !y1 '_�, Located At o�ct a u ��'" +�u /�aSS Scrial Nimmber �'O� M] j , REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Donble Check Valve Asaembly . ` lst Check 2nd Cbecl: Relief Valve Air In��t Check Valve Inidal Test DGClosed Closed Ti,Qht Opened at Opened at �sid Ti�t Leal:ed ❑ �nsid __nsid �o.S � RP-.���psid � Lea1:e� o y Dia nac opea o r�eai;ed a �� and �� "` . ; . _ . .�,. y ,. � a ��- :� .. _,_ �,� �_,_ r ,,.� ., � . . x - - r - -- - � � --- . � ._ �_ , ,..�_ .. . Usod � - �- �. . � - .�. , _ Test Aftet DC-Closed Closed Tight o Opeaed at Opeaod at nsid � Repair ?ighL o �sid __osid RP sid The above is catified to be true. Firm Name D� u ei-.�� �,��. �;r�. Certifiod Testet �er e. IC PC�t�'s Firm Address s�`!1.�„N1,�� Cert. Testar No.C��o 6 !s�Q9 Date � , ! � F��Y 4.�4,ti,�Y �6��� a , � �g� � �20 �a,� � A � llate last accuracy tested �� o! White- Customer's Copy Yellow - City Copy Pink-Tester's Copy �. C�IECK ONE: IRRIGATION DOMESTIC FIRELINE —_� BAC'K�7.OW PREVENTION ASSEMBI.Y TES?AND M�IN3'E1�ArtC'�REPOR? } Na�oF Pws: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: I y I � � , ��ay�,�,u L c� I�-@ The bacl�low preveation assembly detailed below has bxn tested sad maintain� � n�� �, 'T'�gCC regulanons aad is caaified w be operating within acceptable parameters. , ; � ar _ . - �„ _, ,r �. '. �T_�'P�,Op�F A.SS�L�' � �. ' �.- a - -� - � - � e � Reduced Piessurc Pr�iaciple ❑ PressurC Vacuum�Brbaker � Double Chxk Valve o Amiosphere Vacuum Breal:er , Maaufactsaer w a•� S Siu 3/`f / Model Ivumber � d 7 I►� 1 (�?T Located At s�" o�u �� b u e a s.s serial N�ber 2 0 � � � s ) REDUCED PRESSURE PRINCIPLE A�SEMBLY�, �RESSURE VACUUM BREAKER � ,, � `.n, ' ;: Double Check Valve A�s4mb1Y: , �„ "E lst Check 2nd Chec1:` Relief�alve Air I�let Cbeck Valve � Inival Test DGClosed Closed Ti,pht Opcned at Opened at _esid Tight Leal:ed o _osid _�sid (�j�,j�� RP-�psid � . � 1 L,eaI:ed ❑ Did not Opea O Leai:ed O RePairs and . �, .. � _a_ � .„ c „ � - ., __ ,.. _ , _ , �_ . r :,� . < ..� . � .. .' n A ,.;:. . � F � � ��.�M�.;� � .� �,_;;-� r 1' .4 . W'.� � .,., ,,., .�e� USCd „r .., i f Test Aftet DGClosed Closed Tight o ppeaed at ppeaed at ��d Repair TighL o _�esid �sid R.P sid � ,, The above is certified to be true. , Fum Name ��v u- t;�r'e� �;r� Catified TesLa �P�r e�' �e�er 1 ; � Firm Address �` �- Cat Testv No. Q Po o I Sg a 9 Date i o � �orT ��r�►� � �]�ol�� � (�8uge # ��(O S O 1 '"S 0 5 llate last accuracy tested $ , / � White- Customer's Copy Yellow-t�ity Co�y Pink-Tester's Copy . .,g, C�IECK ONE: IRRIGATION DOMESTIC FIRELINE . . . . , . . �.' . ,�. �'. . ., r., BACI�'LOW PREVEP�'TION AS�FM$LY�'ES?Al►�T�J N�3VTE�t.4�1�ItEPORT ' � . ,,; , - : , ; NAME OF PWS: : CITY OF COPPELL - 3 PWS I.D. # LOCATION OF SERVICE: I� �� � , . Q na . L�.K 2 The bacl�low prevtation assembly detailed below has baa tested and ma��t�ed as required by TNRCC regulations and is catified w be operating withia acceptable parameters. _ � ;� ,_ � �� >, . ,� f �,� � . a Tl'PE Q'F ASS�vi�Pressur�Va� :,.��,. ,, i e} , �. - -�. I � . 4 . :� ' ' �` .� .�Y`� ._. . � .., � Reduced Pressvre Principle '� ,' ❑ � cut�Br�aker � Double Check Valve� ��ty���r ❑ Atmosphere Vacuum Breaker Manufacaaer In�a� S Siu � I , Model Ivumber �S� Located At �dt c �°`� I�a i, ��-- Serial Nimmber I� ' �.`1 b � 'y � � �. " REDUCED PR�SSURE PRINCTPLE A�SSEI�LBLY�;, ` RE5SURE VACUU1wI BREAKER; . , . . Doubie Check Valve �imbl `� � ;, �� , , �,� ' ~ lst Check 2nd Checl:i ' Relief�alve Air Inlet Check Valve Inival Test DGClosed Closed Tight Opeaed at Opened at nsid Tight , Leal:ed o nsid __,esid �,s � RP- � � sid � � Leal:ed a �� � Did not Opea o Leal:ed o RePairs , aad - .. . ,n . , ,;: �.,.,� . .. .� ,:� _ . �,: , �. �_ �� r� i � ", '� '� ,�- � ',�`' .�- ��� ,' �` a �° ._ ���� . '�� ��Usod ` a �� a , `'�� �� � Test After DC-Closed Closed Tight a Opeaed at Opeaed at nsid ' _� � Repair Tight ❑ __osid ,_osid RP sid _ The above is cerdfied to be true. Firm Name �►u e.-�;�'%�� �:. r� Catifiod Testa �e�C �e frr i = f4 * �' " Firm Address 5�1� 1 ;/�l��,,.,�_ Cert. Testc No. o Date I � � � �ort i.Jor��`r� �C ��01� '� ; _ i G8� � 1�1 b So I � O F Date last accuracy tested / � o White- Customer's Copy Yellow - City Copy Pink-Tester's Copy C�IECK ONE: . IRRIGATION DOMESTIC FIRELINE � BAC�'LOW'FRE�NTI�N�ASSEI�BL'Y TES?�1t�?�ENANCE REPORT" ;. ��' �� -NAME OF PWS: Cl3'�'OF COPPELL � PWS I.D. # �_ � LOCATTOIv oF sExvicE: I 41 t� � , ��,��; N L �1 C P The bacl�low preveation asscmbly detailed below has beea tested and maintained as required bv TNRCC re_¢ulations aad is cetified to be operating within acceptable parameters. , , � _. �� � t� .. . ? �� ��;. . �J ��i � � • p � AJJ��L.� � �': !j- � ' � ,� � � ''� e Reduced Pressure P�inciple� ��OF I , - �' � � F Pressvre Va �� ���B�eaker � Double Chxk Valve ����eL-{v� o Amnosphere Vacuum Breal:er r� Maaufacnaer ���s Siu � Modei Number �7 5 �7 Located At Init�s� V c�u ��'" Sesial N�ber � � � � '�'�- ',;, '��: � ,� : < , , -°� , , ,_ . ` : ` '. ' RE'DUCED PRESSURE PRINC�LE�r�������. , SSLI�E VACUiTM B�R `. `Double�eck Valvr bl '` ' � ��� �' `� lst C3eck 2ad Checl: Rdie�,�alve Air I et Check Valve Ininal Test DGClosed Closed Ti,�ht Opened at Opeaed at nsid Tight Lcal:ed ❑ _nsid __,esid �,; ��� 5 3 R.P-�•Z,psid Z � Leal:ed ❑ � � t� Did nor Opm O Leal:ed O RePairs aad � �."` -'4° '.��> �,ti ��o-r.. .�.���,.o�_� .,_�,,. �j ''c:� ,ti��� w`� wt,Y ay ,.�a,��,a�+n(��.w�•'^�h tt+ a�,.r,:..r�:� y ,wr�,'x� k: r w�4�s� 'aw ' '�v ��� - Us�d�' � � , �- f � q ..<, a `;, r� ��� vs :•,�, r + � . �� ,. Test ARer DGClosed Closod Tight o pp��az ppeaod ac _�n.sid i Repair ?ight, o �sid _osid ' R.P sid ', The above is cenified to be true. � Fi:m Name Di Uers� �%r�1 ��re. Cetified TGstc � �-e� pe f�� Firm Addres.s S y'�1 ,N'I� d w�.,, � Cat T'e�stc No.f�P��,b'� Date � � _� , �o r�} �,.1 or�i�.,��( ��"I�� , ;`� GBuge # I 2-�a 5 0 1�D � �� � Date last accuracy tested .5' / Z o White- Customer's Copy Yellow - City Copy Pink-Tester's Copy