RPZ_2016_1130 C�IECK ONE:
IRRIGATION DOMESTIC FIRELINE
BACKFLOW PREVENTION ASSEMBLY TES?AND MAIIV'I'ENNANCE REPORT
NAIv�OF PWS: CITY OF COPPELL
PWS I.D.# Wendy's
LOCATION OF SERVICE: 1�2 N. Denton Tap Rd.
The bacl�Iow prevention assembly detailed below has beea tested and maiatained as required by TNRCC
rcgularions and is cenified to be operaring withia acceptablc parameters.
/ TYPE OF ASSEMBLY
�.� Reduced Pressvrc Principle C Pressure Vacu�Breaker
� Double Checic Valve o Atmosphere Vacuum Breaker
, Y�,�
M�,��a ���� s�
��N�� SS��M3(�'T Located At c�� o�s��e � ���-��,e���
serial Nimnber QR�$Q'
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUtJM BRF.AI�R
Double Check�a1ve Assembiy
lst Check 2nd Checl: 'ef Valve Air Inlet Check Valve
Inidal Test DC-Closed losed Tisht at ��at °�d
Tight Leal:ed o `�.psid osid
�C�� R,p- '�'�psid �,�,, �
�� ❑ Did not Opea O Leal:ed �
�P�
aad
Mataials
Usod
rac at� Dc-ci��a ci�a r;�c o o��� o��a� fl�d
Repair Tighi 0 �sid vsid
Itp sid
The above is certified to be true.
Fi�mName Allied Flow Specialists, inc. CertifiedTesta Christopher L. Coffman
' PO Box 1150 Midlothian,TX 76065 �,T�Na BP0016261 D� �'��l��
I FITai�['CSS
II Ga e 05141063
� �
'� Date last accuracy tested �-21-16
I
White-Customer's Copy Yellow -City Copy Pink-Tester's Cvpy