1204W_BethelRd__75019_30512 BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT
City:Coppell
PWS I.D.:0570040
Address:816 S.Coppell Road
Coppell,Texas 75019
Phone:972-462-5150
Contact Person:Jerry Davis
Catalog No: TXTCOP-22380
Result: Passed
Account Name : Current Water Customer
Address of Assembly : 1204 W.Bethel Rd.
Address Type : Commercial
Inspection
The backflow prevention assembly detailed below has been tested as required by TCEQ regulations and is certified to be
operating within acceptable parameters.
Type of Assembly :Double Check Valve Frequency :Annual
Manufacturer :Febco Model No :850 Size :2 Serial No :H46823
Location At:@ meter
What does this serve? Irrigation
Is the assembly installed in accordance with manufacturer recommendations and/or local codes?Yes
Reduced Pressure Principle Assembly Pressure Vacuum Breaker
Double Check Valve Assembly
1st check 2nd check Relief Valve Air Inlet Check Valve
Held at 3 psid
Closed Tight
Leaked
Held at 3 psid
Closed Tight
Leaked
Opened at psid
Did not open
Opened at psid
Did not open
Held at psid
Leaked
Repairs and Materials Used
Test Results after Repair
1st check 2nd check Relief Valve Air Inlet Check Valve
Held at psid
Closed Tight
Leaked
Held at psid
Closed Tight
Leaked
Opened at psid Opened at psid Held at psid
Remarks :
Test gauge used : Potable
Make : MacArthur G Model : 845-5-0006 Serial No. : 03050223 Date Tested for Accuracy : 4/5/2017
The above is certified to be true at the time of testing.
Firm name : Fire &Life Safety America Certified Tester : Henry Pios
Firm Address : 2821 W Euless Blvd Certified Tester No. : BP0013269 Exp.Date : 08/18/2019
Firm Phone No : 972-224-9380 Test Date : 8/28/2017
*Test Records must be kept for at least three years.
**Use only manufacturer's replacement parts.
The following form must be completed for each assembly tested.