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449BethelRd__75109_31157 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-22377 Result: Passed Account Name : Current Water Customer Address of Assembly : 449 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 :Reduced Pressure Principle Frequency :Annual Manufacturer :Apollo Model No :RPLF4A Size :1/2 Serial No :728680 Location At:In kitchen @ soda rack What does this serve? Domestic 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 6.8 psid Closed Tight Leaked Held at 7 psid Closed Tight Leaked Opened at 2.2 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 : Mid-West Model : 845-3-0018 Serial No. : 12131056 Date Tested for Accuracy : 2/8/2017 The above is certified to be true at the time of testing. Firm name : DFS Fire Systems Certified Tester : Billy Franklin Firm Address : 885 E.Collins Blvd Suite 104 Certified Tester No. : BP0016888 Exp.Date : 10/19/2018 Firm Phone No : 214-628-4061 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.