2016_0614 �-`�
C�iBCK ONE: �
IRRIGATION DOMESTIC FIRBLINE
:�.
BACKI�7.OW PREVENTION ASSEMBLY TEST AND NtAI1V'R'ENANCE REPOR?
NAlv�OF PWS: CITY OF COPPELL „N� �
PWS I.D.# �t1��ay �: �iC'ari�
LOCATION OF SERVICE: I�`�T lV. ��Ari'� R�.
The bacl�low preveation assembly decailed below h� bem tesud aad m�intain� � � �, 'I'NRCC
regtilaaons and is ctrcified to be opezating withia acceptable paramtters.
TYPE OF ASSEMBLY
C,1 Reduced Pressurc Principle e Pressure Vacu�Bnaker
� Doubk Chxk Valve ❑ Atmosphere"Vacnum Breaker
�.t:, Maaufactiaer �°�1T�-a S iu 4�`•
� � Modei Ivumber ���M � QT Located At � ✓h�� �#�l �1t�t�`��.
� L!
Scrial Nimmbc � �T�-'�"��
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REDUCED PRESSiJRE PRINCIPLE ASSEMBLY PRESSURE VACiJUM BREAI�R � �
�r
Double Cherk Valve Assembly
>
; G; lst Check 2nd Checl: 'ef Valve Air Inlet Check Valve
Ininal Test DC-Closed Closed Ti,rht Opened at Opeaed at _�sid ,
'�y,�jS/-t�. Ti � Leal:ed ❑ �_nsid __nsid
'�� R.P�_psid �,,�
Leal:od O Did not Opea O Leal;e�i D
RePairs
aad
Mataials
Used x�
Test ARer DC-Closed Closed Tight o Opeaed at Opened at �sid
Repair Tight o �sid esid
RP sid
The above is catified to be true.
Firm Name Allied Flow Specialists, inc. ���;� Christopher L. Coffman '�,
I ,�/ �w��
! Fn'�3A�SP0 Box 1150 Midlothian,TX 76065 Celt.TesterNo. BP0016261 ]�� �' !T"l�p ��`; i
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Gauge # 05141063 �
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' Date last accuracy tested 8-12-1�,f
I White-C�tomer's Copy Yellow - City Copy Pink-Tester's Copy