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2014_0528 . .,-..,. .... _ _�,_,,,�.,.„„� _.,.a�,>,>..,< .Y.a..�, .. ,«�.. ...... . ._ .,.. _ _ , , _. . f � .t � , ,,� ,.�`"° `� { g 4 ' " C�IBCK ONE: IRRIGATION � DOMESTIC FIR.ELINE� >,_,�. ,: BACI4LOW PREVENTION ASSEMBLY TEST AND MAINrENANCE REPORT x�oF Pws: CITY OF COPPELL PWS I.D.# � .LOCATION OF SERVICE: 51D� L�.lr� � �Gl,iC,�, . e.l I��c��o �� . , The bacl�low preventioa assembly detailal below has bxa tested and mainsaiaed bs requirrd by TNRCC reguladons aad is catified w be opaating within ac�xptable pa�aometers. TYPE OF ASSENIDLY C Reduced Pn�ssurc Priaciple e Pressure Vacinmm Breaiaer � , 53'� Doubie Chxk VaIve o A�osphere Vacuum Brealtr �� �i � M�� �r�bc 0 s� ' Mode1 N�bcr ��Q Locaud At �,ylC��,b��Q�k GI_np� .�� 't;Y(�Y)`� �l���� Scrial N�mmber �Ci�� ��� - REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE V�iCUiJM BRFAKER �����1 Double Check Valve Asaembly . lst Check 2nd Check Rdi�f�atvr Air Iniet Cl�edc Vaive � � Inival Test DC-Closed Closed Ti�ht Opeaed at Opeacd at �d , Tig� � Leal:ed� o flsid _osid , Rp-=?sid , � o D i d nat O p e a a L e a ti:e d � �� . � �o N �' NaN�' Maurials Used Tasc ARer DC-Closed Ciosed?ighc . o .Opeaed at Opmsd ac �sid �� �� a nsid osid • RP � 'd The above is caaBe�to be true. _ F'um Name AV�I P l�S �C k G� Catifiod Testa C�.0 I� /�1�1 Q� (r5 F�����t;�1��,�i�a�. G����12� cac T�xoF�PdD(��51�1 � 5 Z � . �T� �-r�03�o � � ���` �� Gauge # (�(�n ?��� . . ,� . , �>. Date]ast accuracy tested � l� - F �,. . ,._,�� ' .;� White—Customer's Copy _ Yellow—City Copy Pink—Tester's Copy i , . � � � � --.- ' - .. . . , .._ , Scanned by CamScanner