2016_0824 C�IECK ONE:
IRRIGATION DOMESTIC FIRELINB
BACI�LOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPOR?
NAI�OF PWS: CITY OF COPPELL
PWS I.D.# 51ne1� C-x��e.��,y
LOCATION OF SERVICE: IO�� R4�IAI � • , Co�I. T�C �T S�1�
T'Se bacl�low preveation asscmbly detailed below has bem usud and main(ain� � �� by TNRCC
regulauons and is certified to be operating withia acceptable parameters.
/ TYPE OF ASSEMBLY
L� Reduced Pressure Principle C Pressure Vacu�Breaker
❑ Dauble Check Valve ❑ A�osphere Vacuum Breaker
,-r Y�.
Maaufacz�er W'�� Size
Modei Ivumber � o��� Lacated At li�e.c dc��k s��-i o� i/l lo��/
Serial N�ber 1 1'�/�c��
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAI�R
Double Check Valve Assembly
lst Check 2nd Checl: Relief Vaive Air Inlet Check Vaive
Iniaal Test DGClosed Closed Tight o �at Opened ac osid
$-1?-1 b Tigi�t ❑ Leaked o �i i�l sid nsid
� � R.p-__,psid
q� i � o �a no�op� o r�:�a �
g�pairs i � 0. ( ��- �� � c�con ec �tv; 5;�e.
a�a 'lo�ck o� �o � Co�'� "�{�
Mataials
Used
T DC-Closed Closed Tight O�ened si Opmai at nsid
� T;� g � �3 g psid nsid
S S � . �a
The above is artified to be true.
Firm Name Allied Flow Specialists, inc. Ccrtified Testa Christopher L. Coffman
' Fi�mAddnssPo BoX 1i5o M�diotn�ar,,TX 76065 ��,TestcNo. BP0016261 D� ��y-f�
I Gauge # 05141063
Date last accuracy tested 7-21-16
White- Customer's Copy Yellow - City Copy Pink-Tester's Copy
C�IBCK ONE: /
/
IxRIGATTON DOMESTIC �� FIRELINE
BACI�LOW PREVENTION ASSEMBLY'TES'T AND MAINI'ENANCE REPOR?
NAIv�OF PWS: CITY OF COPPELL
PWS I.D.# �heil �ewav
LOCATION OF SERVICE: I�O� Roya� L�. , Co �e�Tf C '7�O1 g
The bacl�low prevention assembly c3erailed below has beea usud and maintainod as required by TNRCC
regularions aad is cerdfied to be operating withia acceptable parameters.
/ TYPE OF ASSEMBLY
L�� Rcduced Pressur�c Principle e Pmsure Vacu�Breaker
� Double Check Valve ❑ A�aosphae Vacuum Bnaker
YV� •`
Maaufacturer S� �
ModelIv�ber 0���� LocatedAt � fEr+C o� ����`� C9c�
Serial N�ber !'1'D ow�?0
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUTJM BREAI�R
Double Check V alve Assembly
lst Check 2nd Checl+ Relief Valve Air Inlet Check Valve
Initial Test DC-Closcd Closed Tight ❑ at Opeaed at osid
��'7 j(o Tight ❑ Leal:ed C �7 ..psid ,osid
�� � RP• �•�psid {�.p � �
�;� Did not Opea o Leal:ed
gtpaire i�n5�� g e�1o�;
aad
Mataials
Used
Test � DC-Closed Closed Tight at Opeaod at nsid
air Tight c� O��sid csid
5 s RP '� sid o'�
The above is catified to be fiu.
Firm Name �Ilied Flow Specialists, �nc. Certified Tester Christopher L. Coffman
I FIT�iA�CSSPO Box 1150 Midlothian,TX 76065 C�,'I'atQrjO. BP0016261 D� $2Y 1G
Gauge # 05141063
Date last accuracy tested �-21-16
White-Customer's Copy Yellow - City Copy Pink-Tester's Copy