The URL can be used to link to this page

2015_1124 C�IECK ONE: IRRIGATION DOMESTIC ✓ FIRELINE BACI�Z,OW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT N�OF Pws: CITY OF COPPELL PWS I.D.# �Lp�S �ZZ�a Z LOCATION OF SERVICE: //Z- N- �_ T� R� • The bacl�low prevmtioa assembly derailed below has beea tested aad maint�n� � nq�� by TNRCC re_guladons and is ceroified to be operating withia acceptable parameters. TYPE OF ASSEMBLY C / Reduced Pressure Principle ❑ Pressurc Vacu�Brealcer :�f Double Chak VaIve o Atmosphere Vacuum Breaker Maaufacaaer /el��/�n� Siu ��i Model Number �sOJC L Located At � . Serial Nimmber Z�� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check v alve Assembly lst Check 2nd Checi: Relief Valve Air Inlet Check Valve Inidal Test DGClosed losed Tight Opened at Opened at osid Tight,Z. � Leal:ed ❑ vsid _osid � RP-_psid �_ L 1,�;� p Did aot Opea o Leal►ed � airs and Materials Used Test ARer DC•Closed Closed Tight o Opeaed at Opeaed at _.�sid Repair Tight ❑ �sid osid R.p sid The above is ceRified to be true. Firm Name �e ` Cedfied Tester � Firm �0 �/� '�_r��✓"eert.Testa No. 0 Date �Z '�� 7(ooG¢f Gauge # llate last accuracy tested ' Z "/� "�� White- Customer's Copy Yellow - City Copy Pink-Tester's Copy C�IECK ONE: IR.RIGATION_� DOMESTIC FIRELINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT NAME OF PWS: CITY OF COPPELL PWS I.D.# l�,�ti..�.t�Z��Zf LOCATTON OF SERVICE: /�Z /V/. ,C1� T!� �. The bacl�low prevmtion assembly detailed below has bcea tested aad ma�ni�ed as required by TNRCC regulauons and is cerdfied to be operating within acceptable parameters. TYPE OF ASSEMBLY e Reduced Pressure Principle C Pnessure Vacuimm Breaker � Double Check Valvc o Atmosphere Vacuum Breaker Maaufactiaer � n Siu /�z� Modei Nimmber �T a/!1�A Z� Located At /�,/' /'�, � �o�.��• Scrial N�ber L,'i.33� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Doubie Cheek Valve Assembly lst Check 2nd Checl: Relief Valve Air Inlet Check Valve Inidal Test DC•Closed Closed Tight Opened at Opened at osid Tight �. .�j Leal:ed o �sid __osid R.P-_psid ,� L,�;� ❑ /�� Did aot Opea o Leal:ed o airs aad Materials Usod Test After DC-Closed Closed Tight o ppeaed at Opeaed at _�sid Repair Tight � Dsid osid R.P sid The above is cerdfied to be true. � � Firm Name . Certifiod Te.sta Firm Ad�°1� �= ��ert. Tastc No 0 / Dace 'Z� — .f 7�raCr,S' (�suge # (�(Ap—T� � !1� llate last accuracy tested � White- Customer's Copy Yellow - City Copy Pink-Tester's Copy