The URL can be used to link to this page

RPZ_2016_0108 CHECK ONE: / / IRRIGATION DOMESTIC ,� FIRELINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANC�REPORT' NAME OF PWS: CITY OF COPPELL PWS I.D.# LOCATION OF SERVICE: �Q� 1��A�l C!�� t. �u��C- I�� : The bac}�low prevmdon assembly detailed below has b�ea ustcd and m�in�ain� � � bv INRCC reguladons and is cerafied to be operating withia acceptable parameters. TYPE OF ASSEMBLY Reduced Prassure Principle C Pressore Vacu�Breaker ❑ Double Check VaIve ❑ A�os�here Vacuum Breaker Maaufact�er ��•� Siu ��. • Model N�ber 1-�"'��.i�m' �� Locaud At I�.+�at��l�;�t�t; � i.d�l�1' �p�q� '�rt rC Serial Nimmbc �� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�iCUUM BREAI�R Double Check Valve Assembly lst Check 2ad Checl: Relief�alve Air Inlet Check Vaive Inival Test DC-Closed losed Tight �at Opened at nsid �-�-�i�,, Ti� Leal:ed ❑ nsid nsid �- �"'�Ds�d �ss r��k:�� ',�',,�, �-�►� � ,�;L► �1=C�� Did not Opea O I.eal:ed � �� 1�� Maurials �'C•�� 'n Used ,�%i� M1�J � �� Test ARtr DC-Closed losed Tight e¢at Opmed at esid ltep ' �� Ti � •�! � ��psid nsid �� Rp a s�i The above is catified to be true. FicmName Allied Flow Specialists, inc. Cercifie�Tester Christopher L. Coffman PO Box 1150 Midlothian,TX 76065 BP0016261 ��l> I�I Firm Address Cat Tasta No. Date 1= II� Ga # 05141063 � I Date last accuracy tested 8-12-15 White-Customer's Copy Yellow - City Copy Pink-TesteCs Copy CFIECK ONE: IRRIGATION DOMESTIC V FIRELINE BACI�Z.OW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPOR? NAI�OF PWS: CITY OF COPPE�L PWS I.D.# LOCATION OF SERVTCE: �Q � IJ�J� C�1�;�}e-+ ��• =-��i��l Q� Thc bacL�flow prcvmrioa asscmbly detailed bdow has beea usud and maintained as required bv TNRCC naulations and is certified to be operating withia acceptablc paramtters. TYPE OF ASSEMBLY Reduced PreSsure Principle C Pressure Vacu�Breaker � Double Check Valve ❑ Amiosphere Vacuum Bnaker �-If � +i Maaufact�er �✓�'�=1� Siu �i� Model Nimmber ��'�"�:/��Q� Locaud At �1n E�11+��3�.-�� S ��k�'�a+t� � p Serial Nimmber �J�I��O SQP�'"�� `� — �� REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R Double Check Valve Assembly lst Check 2nd Checl: 'ef Valve Air ldet C3eck Valve Inidal Test DGClosed Closed Tight Opfped at Opeaed at esid �-�- �f1 Tight � Leal:ed o 7�� sid nsid RP•�psid �.o� c�l�� I,�;� ❑ Did aot Open ❑ L,ea1:e� � �P� and Materials Used Test After DC-Closed Closed Tight o Opeaed at Opmed at nsid Repair Tight � nsid nsid RP sid The above is cctifiod to be true. Fi�mName Allied Flow Specialists, �nc. ��T� Christopher L. Coffman FirmAdd�SSPO Box 1150 Midlothian,TX 76065 CeR TesterNo. BP0016261 D� �' �- 1� �!, Gauge # 05141063 ' Date last accuracy tested 8-12-15 i' � White-Customer's Copy Yellow - City Copy Pink-Tester s Copy