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2016_0817 (2)
C�IECK ONE: I$RIGATION DOMESTIC FIRELINE BACI�LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPOR? n� NAI�OF PWS: CITY OF COPPELL PWS I.D.# She41 Gateway LOCATION OF SERVICE: 1000 Royal Ln., Coppell, TX 75019 T'hc bacl�low preveation assembly detailed below has beea testod aad maintained as nquired by TNRCC reguladons aad is certified to be operating withia accaptable parameters. � TYPE OF ASSEMBLY Reduced Pressure Priaciple C Pressure Vacu�Br�caker = Double Check Valve o Atmosphere Vacuum Breaker � �) �j � V �. Maaufactzacr �►"�11 T� Siu 7'1 Modei Ivt�ber 41���•7 Locaud At G[/!G�1' ���k �t9t�d�n i•1 ���i�.iy A o�,,��� � s«;�N�ba REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BRFAKFR Double Check valve Assembly lst Check 2nd Checl: Reiief Valve Air Ialet Checic Valve Inival Tat DC-Closed Closed Ti,Qht ❑ Opened at Opeaed as nsid � �'�_�� Tidit ❑ Leal:ed � nsid osid RP-_psid I�•�k►�,y� �; I Leaked o 9 Dia noc Open o I.esl�ed J Repair� Vc��v� q�� }e�i �� 5���.�5 d�SCo,nnee M �ks 1►K �+� � ,�� �,� �`�c�� re �.� q� u�a � 1��- ;�- ec���y� � c,a ;Q 1P Test Afttr DC-Closed Closed Tigi�t o Opea at Opcned at nsid Rtpair TighL ❑ �sid osid R.P sid The above is cerrified to be true. Fi:mName Allied Flow Specialists, inc. �errifie�Tener Christopher L. Coffman FitmAddreuPO Box 1150 Midlothian,TX 76065 Cat TesterNo. BP0016261 D� 8/17/16 Gauge �k 05141063 Date last accuracy tested 7-21-16 White- Customer's Copy Yellow - City Copy Pink-Testet's Copy