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2015_1019
C�iBCK ONE: IR.RIGATION DOMESTIC FIRELINE �'"� BAC�'LOW PREVENTTON ASSEMBLY TES?AND MAINTENANCE REPORT NAIv�OF PWS: CITY OF COPPELL PWS I.D. # LOCATTON OF SERVICE: °. ;�:�: � i - � s ' � � � ,� :3 s,E� f -�° 7�, P �,,,�, ��;.- -�1., , ( The bacl�low preveation asscmbly detailed below has been tested aad ma�n air� � nq�� � �CC re_evladons aad is cerdfied to be opera�ng within acceptable paramcters. TYPE OF ASSEMBLY e Reduced Pressure Principle ❑ Pressvre Vacui�Breaker �`' Double Check Valve o Amnosphere Vacuum Breaker Manufactiaer i 1 � I ��_ � .� � Siu � �--- Model Number � � �, ��/� Located At J� �„ �� ��-- ;� � � � , I ;� ;�s Serial N�ber f�.� `�1 � �'� '-� _ ..i�.�,. � � , � i.� P� �� -�� ,,.-. � REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check Valve Assembly lst Check 2nd Ch�cl: Relief Valve Air Inlet Check Vaive ; Inival Test DGClosed - ' f Closed Tight Opened at Opened at osid Tighi Leal:ed o osid _osid RP-_psid � � Leal:ed ❑ Did not Opea o L,eal:ed O �P� and Mataials Used Test ARer DGClosed Closod Tighi o Opened at Opeaed at �sid Repair Tight o �sid csid R.P sid The above is cerdfiod to be�ue. � _, ;.< ,� � L� , ( _�' � ,' �__. Firm Name ;��''l��� � C� C( �jr+ �d{��`�i.vCatified Teste "� k�- ��� � �t�t if c'.��"a, Firm Add�ess�i��`�'�:'� �'�� ''� � 1 Cert. Tester Na � � �`�;' Date � � � f`' � � ` ,�� � � �'�, �;� �,i r;l � �";%,� ���;�,� -� ...; � s (�auge # �"%// `r'. ��t �' llate last accuracy tested � �(�-��� White- Customer's Copy ' Yellow - City Copy Pink-Tester's Copy _ _ __ _ _ _ _ __ _ C�IECK ONE: IRRIGATION DOMESTIC FIRELINE � BACKFLOW PREVENTION ASSEMBLY TES?AND MAINTENANCE REPORT NAN�OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE:�� �51, < < �� `�r�d, �>I��� ( � �'" � i:,_, f 5 .. �� � ( The bacl�low preveation assembly dctaile� below has beea tested aad maiatained as required by TNRCC regulations aad is cerafied W be operating within acceptable parametets. TYPE OF ASSEMBLY C Reduced Pressure Principle e Pressure Vacu�Breaker � Double Check Valve o Amnosphere Vacuum Breaker Manufactsaer P3_ �, I ��:� ��, s Siu ��`t Model Numbcr ``�' ti `-, �``� �� Locaud At V=-�� �� ��^ ►�� �-�, ., ! ,J� t,.-� � -- �'^ '� L�r." J I L. .�. � .�-,�..-•C..�•- Serial Nimiber ->'� ?� C� �`� � REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check v alve Assembly � lst Check 2nd Checl: ReIief Valve Air Inlet Check Valve Ininal Test DGClosed �--y Closed Ti,�ht ❑ Opened at Opened at osid Tight � Leal:ed �sid _osid RP-_psid � Leal;ed Did not Opea o Leal:ed J �31lS � .� ; � t� +--,v� , c/ � l.. �-'" ie^` Materials ,�, �. �- �, '' � Used Test ARer DC-Closed ( `� Closed Tight Opeaed at Opeaed at __nsid Repair Tight � � �Dsid �osid RP sid � The above is ce�tifiod to be true. _..� . � ;' �� h( .4 1 .�,� ��[�' �•,,'.�t.;^ ..� ,�.,r•._� Firm Name�Z �.t l _�l' �°=f('���.�-.�`Certifiod Tester ` � -� , �- Firm Addres� �'� 'l��a��'��. 3�� ��-�� Cert. Taster No. �'����`���_�� �� r �--._ �� ,� ��;t� °�r;i7 ,;�i!� �?� f.�l :� % > � � cg� � � �, I (� � �.:� llate last accuracy tested - C�-,� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy C�IECK ONE: IRRIGATION DOMESTIC FIRELINE � BACI�'LOW PREVENTION ASSEMBLY TEST AND MAIIV'I'ENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # , LOCATTON OF SERVICE:�c;:�, � s � ;� ; �, '� ,.�-�* .� 1�J;Jr � Z- ��� r 1� �: x �'L. c I The bacl��flow prcvmtion asscmbly detailed below has beea tested aad maintain� � nq� �, 'I'NRCC regulations and is cerd5ed to be operating withia acceptable parameters. TYPE OF ASSEMBLY e Reduced Pressure Priaciple C Pressvre Vacu«Breaker 3'" Double Chcck Valvc o Atmosphere Vacuum Breaker Maaufactsaer �_,.--�, ! �� r� �, Sizc � `Z � � Model Number � � � �>;�� Located At ��r�:.��� ' � u,,., f-� � �-, . � Serial Nimmber /� �i 2 Zy ? '� �'�r, < �,� � � �.- y., L REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check v alve Assembly lst Check 2nd Checl: Relief Valve Air Inlet Checic Valve Inival Test DGClosed � � Closed Ti,Pht Opened at Opened at _nsid Tight Leal:ed ❑ �nsid __nsid RP-__psid 2 `-� Leal:ed o Did not Opea O I,eaked o �P� aad Macerials Usod Test ARer DGClosed Closod Tight o ppGned at ppeaed ac _�sid Repair Tight o �sid osid RP sid The above is cerdfied to be true. - Firm Name ��t)1��'�!.�_1 ��l'r� ���'9 ;� �'.j i�(.;c�� Certifiod Tester �� ' °�� �� ��' �`�`�r a t��'E1�ri_. Firm Address I r ���='� � J`'`� �v� � Cat Testc No. `��{��"'�k°„ Date � � `' ,� -, . �:�,;t�� `�1't�� �'� 1` :�p-�� � �� J� _� -� ,;?, Gauge � ��'� � � � �µ� llate last accuracy tested ff ���' -�._ White - Customer's Copy Yellow - City Copy Pink-Tester's Copy C�IBCK ONE: IRRIGATION DOMESTIC FIRELINE ✓�/ BACI�Z.OW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: :-� � s �,� : ;� �_ � � -, f���,; / z ��- � �.,� t �t ��-..� I The bacl�low prevmtioa asscmbly detaile� below has beea tested aad maintained as required bv 'INRCC re,�guladons and is cerdfied to be operating within acceptable parameters. TYPE OF ASSEMBLY C Reduced Pressvre Principle C Pressur�Vacu�Breaker �� Double Check Valve o Amnosphere Vacuum Breaker Manufact�er L..l, I k ,., s gue `e`-� `�--j' � (.,,}�-tr (�� � i �' Model N�ber Located At V��,� � E,.., �_ �. y r I � , 1- Scrial Ni�ber � '� y � `��``� � �`,� �� c !-�. .>,. 4- REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check Valve Assembly lst Check 2nd Checl: Reiief Valv� Air Inlet Check Valve Initial Test DGClosed �--' Closed Ti�ht ❑ Opeaed at Opeaed at _nsid Tidst ❑ Leal:ed nsid _osid R.P-_psid `�'' Leal:ed Did not Opea o Leal:ed � Repairs �� � j�,. �., ,r�,0 � � -,��- , d,f M��+fY� t"f � � � �.. Usod Test AR,er DGClosed 1 �-� Closed Tight Opeaed at Opeaed at nsid _� Repair Tighi 2 , L, �sid �nsid RP sid The above is catified to be true. ". � � � Firm Name���'-'�l� `�`�'� ���```'I������Certifiod Tester ��-� '�� ���� ��� ;'����,� <. �,._�. Firm Address ��. 1'�:.�'� ��' � � �1� Cat Tcstc No. �� � � �� Date I �; _ �`i ; � �,� '. �.�';�} ,J�i � � . ?i �`:a t .�`� y t " �g�e 7� ���� � � 4�`-� '"/,� . �a ` ' � llate last accuracy tested ��' f,i�(�J- ,� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy C�iECK ONE: IR.RIGATION ✓ DOMESTIC FIRELINE BACI�ZOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE:�---���1 � ���_ � ����- � - !5�,�� / ��i� �� r �,�.J �;> ��1_�> I � The bacl�-flow preveation assembly detailed below has beea tasted aad maiatained as required by TNRCC regulations and is certified to be operating withia acceptable parameters. TYPE OF ASSEMHLY C Reduced Pressure Principle � Pressure Vacu�Breaker � Double Check Valve ❑ Atmosphere Vacuum Breaker Maaufact�er �---' , ;+-� `� Siu Z Model Number �f..... (-� t,�� v' ! Located Ai r�^ - �` �, �.�•- ���� � � �- �� }-. :a 1 ._ .-,� �. Sezial Nimmber '-� �' L`� `�/ " REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check Valve Assembly lst Check 2nd Checi: Relief Valve Air Inlet Checic Valve Inival Test DC-Closed ! � Closed Ti;ht Opened at Opened at _nsid Ti�t Leal:ed ❑ �sid _osid R.P-�sid � � Leal:ed o Did not Open O I,eaked � RePairs and Materials Used Test After DC-Closed Closed Tight o ppeaed at Opeaed at _�sid Repair Tight o :nsid _nsid RP sid � T'he above is cctifiod to be true. Firm Name ��V`,�-� f''�`C� �1':�, t r �".f,�'�t-,`Certifiod Testes `:�t � �;�, �`, d r �r -a �, �-���,�, , � ,. , .--� Fitm AddRSS � ���`�`� �'� � y��� f Cert. Testc No. ��? )� , �� Date r � A�; r �.. "- ..3 �,�t1t�1 `.�,t1�1�r4jC.t `j �, �`7� '�7 .� l7g�e * �,� ` 1 t.`��r:.��/� { llate last accuracy tested f!' :��'�� . White - Customer's Copy Yellow - City Copy Pink-Tester's Copy C�IECK ONE: ; IR1tIGATION DOMESTIC FIRELINE BAC�'LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE:L-�...�s � 1 ,� ti `` ',-- � ,� �`>�,�� ( `7 -7.-. r � �;� ��'.,� ( The bacl�low preveation assembly detailod below has beea tested aad maintain� � nq� �, '�CC regulazions and is cerd5ed to be operating within acceptable parameters. TYPE OF ASSEMBLY ❑ Reduced Pressure Principle � Pressure Vacuimm Breaker � Doublc Check Valve ❑ Atmosphere Vacuum Brea�er Maaufact�aer � �� t� '� Siu '� Model Iv�ber c� (��...v?,,�.� r I,ocated At ,�i.- r�4-�� �;��.-. ���,�-�L,� l , , �_ Scrial Ni�ber �� �`? �:� `.ti � i �-�.�F-4. �<<� �� � REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check v alve Assembly lst C3eck 2nd Checl: ��{��ve Air Inlet Check Valve Initial Test DGClosed �' � Closed Ti;ht Opened at Opened at _nsid Tight Leal:ed ❑ �nsid _�sid RP-_psid / t-' Leal:ed o Did not Opea o Leal:ed J �P� and Matcrials Used Test Aftet DC-Closed Closed Tight o pp��az Opeaed at _�sid Repair Tight o _�sid osid RP sid The above is cerdfied to be true. Firm Name �`i)�'�" 4;� � "r� ��,'!�(��"���.�t.., Certified Teste �`-� %� � /�+ � ,x��i� "f"�,��.. ;j Firm Address �" �P" ='�=`=��`��f� Cert. Teste No. ,�,� `a L Date /�_ �� , "�.. . Y ��f l� � '�y,L�; l 1 i ,�t� )`; � ; �' Gauge # �? � � � �^�� �'`' Date last accuracy tested � "�"�� ��� White - Customer's Copy Yellow - City Copy Pink-Tester's Copy C�IECK ONE: 4 � IRRIGATION � DOMESTIC FIRELINS BACT�ZOW PREVENTION ASSEMBLY TEST AND MAIIV'I'ENANCE REPOR? NAME OF PWS: CITY OF COPPELL PWS I.D. # LOCATION OF SERVICE: L_�;� � s ��r � � ' '�-� �-:� ��..i� I Z �� i t� r S-� !-�, , f ' The bacl�-tlow prevtatioa assembly detailed below has beea tested aad maintain� � nq�� bv T'NRCC re_eulations and is cerdfied to be operating within acceptable parameters. TYPE OF ASSEMBLY o Reduced Pressurc Principle � Pmsurc Vacu�Breaker 2�'` Double Check Valve o Atmosphere Vacuum Breaker Manufactsaer ! _,:+�, � � Siu �_ Modei Number � `�� �,U-���� � Located At ,t,-,�' �, � �- �1 ti�--��. ,� f ,, � � � � f���: r�...r v�.�,�� ��r ,r �).., ��� Serial N�ber � '� � REDUCED PRESSiJRE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R � Double Check Valve Assembly lst Check 2nd Checl: Relief Valve Air Inlet Check Vaive - Inival Test DGClosed � `'' Closed Tight Opened at Opened at osid Tight Lcal:ed ❑ �sid __,osid RP-_psid � . � Laal:ed ❑ Did not Opea o 1,eal:od o �P� and Mataials Usod Test Ai3er DC-Closed C2osed Tight a pp��at Opeaed at �sid Repair Tight o �sid _nsid RP sid The above is catified to be true. r ; r, � Firm Name�,�1�r�:�t�E /l �)�tE '�'*����N CC[!1$Od T'CSMCC �� i 1: � �{r`"`� ",i t:; ✓! r,,.__. � Firm Address � 'r,' � �� ��f �� 1 Cert. Testar No. ��1�':�;�-`� � Date i`� , r`'-' r �,� ` :� �.,1'� ? l€ �_iY� � �1 ,� `� , Gauge # r.,, � t ! (r z�;� � llate last accuracy tested ,��` ��'y,� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy _ __ _ _ _