2016_0327 C�iECK ONE:
IRRIGATION DOMESTIC FIRELINE
BACT4'LOW PREVENTTON ASSEMBLY TEST AND MAINTENANCE REPORT
NAME OF PWS: CITY OF COPPELL
PWS I.D. #
LOCATIOIv'OF SERVICE: � � � [ �� � ���S S
The bacl�low prevmtion assembly detaile� below has bem tested aad maintained as required bv TNRCC
regulations aad is certified to be operating within acceptable paramcters.
TYPE OF ASSEMBLY
e Reduced Pressvre Principle e Pressure Vacui�Breaker
y,/ Double Chcck Valvc ❑ Amnosphere Vacuum Bnaker
Manufactsaer � �� Siu 3 �
Model N�ber �S� Located At ��� �
Scrial Nimmber � � �"�� (� �f
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R
Double Cbeck Valve Assembly
lst Check 2nd Chec�: Relief Valve Air Inlet Check Valve
Inival Test DGClosed losed Ti,pht Opeaed at Opeaed at �id
Ti� Leal:ed ❑ _osid _nsid
R.P-�sid �
Leal;ed o � Did not Opea O Leal:ed o
�P�
and
Materials
Usod
Test Aftet DC-Closed Clos�d Tight o ppened at ppeaed at _nsid
Repair Tight ❑ nsid __osid
R.P sid
The above is catifiod to be�ue.
Fum Name���f�-�fA- ��� Catified Testa �� � ����11A
Firm Address �� 1 G�I �.� Cat Tester No.g Q�3���Z Date�<<o
Gauge # �3 l Z �o� �C�7�� I��'
llate last accuracy tested � �r C��
White- Customer's Copy Yellow - City Copy Pink-Tester's Copy
GANDARA IRRIGATION INC.
3901 Clifton Dr. Richardson TX 75082
Office: 972-671-3776
Fax: 972-664-9158
Cell: 972-467-3918
Email: eddiegan1@sbcglobal.net
S�i PREAKNESS
BELMONT LANDING
COPPELL TX
To Whom it May Concern;
An irrigation system was installed at the property described above. In accordance with
the city of Coppell inspection requirements, we are providing the following information.
This irrigation systemhas been installedin accordance with all applicable
State and local laws,ordinances,rules,regulations and orders.
I have tested the system and determined that it has been installed according
to the irrigation plan and is properly adjusted for the most efficient
application of water at this time.
1 year warranty from the day of installation.
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Sincereiy �; =z: �':�a
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EDWARD GANDARA =
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