800WSandyLake_75019_31110 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-22054
Result: Passed
Account Name : Coppell Trade Center
Address of Assembly : 800 W Sandy Lake
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 :805YB Size :3/4 Serial No :Unknown
Location At:SE vault
What does this serve? FireLine
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 1.6 psid
Closed Tight
Leaked
Held at 1.2 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 : Wilkins Model : TG5 Serial No. : 03103451 Date Tested for Accuracy : 6/1/2017
The above is certified to be true at the time of testing.
Firm name : Ideal Fire &Security,LLC Certified Tester : Jeffrey Sands
Firm Address : 6913 Camp Bowie Blvd.Ste.181Certified Tester No. : BP0008021 Exp.Date : 08/17/2018
Firm Phone No : (817)222-1283 Test Date : 9/12/2017
*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.