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670FreeportPkwy__75019_35206 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-22605 Result: Passed Account Name : Tohatsu America Corp. Address of Assembly : 670 Freeport Pkwy. 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 :Wilkins Model No :950XLD Size :3/4 Serial No :3976012 Location At:NW vault on Beltline near yellow hydrant 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 2.8 psid Closed Tight Leaked Held at 2.8 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 :This device is not a double check detector assembly.It is a double check.The location is the same as the8"on beltline in vault near yellow hydrant.The model number is 950XLD. Test gauge used : Potable Make : Apollo Model : 40-200-TK5U Serial No. : 01111188 Date Tested for Accuracy : 2/21/2017 The above is certified to be true at the time of testing. Firm name : Action Fire Pros.Certified Tester : Wesley Higgs Firm Address : 3709 S IH 35 E Certified Tester No. : BP0014258 Exp.Date : 11/30/2017 Firm Phone No : 214-549-7793 Test Date : 11/1/2017 *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.