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NEW_731Plaza_75019_38096 BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT Name of PWS:Coppell PWS I.D.:0570040 Address:816 S.Coppell Road Coppell,Texas 75019 Phone:972-462-5150 Contact Person:Jerry Davis Catalog No: TXTCOP-28262 Test Date: 1/12/2018 Result: Passed Reason for Test: New Account Name : Current Water Customer Address of Assembly : 731 Plaza 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 What does this serve? Domestic Manufacturer :Watts Model No :009m3 Size :3/4 Serial No :165291 Location At:scope processor work room 125 Is the assembly installed in accordance with manufacturer recommendations and/or local codes?Yes Is the assembly installed on a non-potable water supply (auxiliary)?No Reduced Pressure Principle Assembly Pressure Vacuum Breaker Double Check Valve Assembly 1st check 2nd check Relief Valve Air Inlet Check Valve Initial Test Date:1/12/2018 Time:3:00 PM Held at 7.8 psid Closed Tight Leaked Held at 7.6 psid Closed Tight Leaked Opened at 4 psid Did not open Opened at psid Did it fully open Yes No Held at psid Leaked Repairs and Materials Used ** Test After Repair Date: Time: Held at psid Closed Tight Leaked Held at psid Closed Tight Leaked Opened at psid Opened at psid Held at psid ***2nd check:numeric reading required for DCVA only Test gauge used: Potable Make: WATTS Model: TK-99E Serial No.: 0087813 Date Tested for Accuracy: 3/14/2017 Remarks : Firm Name : MECHANICAL PARTNERS Licensed Tester : ROBERT TEETERS Firm Address : 10217 PLANO RD BPAT License # : BP0012791 Firm Phone No : 214-600-9270 License Expiration Date : 01/28/2019 The above is certified to be true at the time of testing. * Test Records must be kept for at least three years.[30 TAC §290.46(B)] ** Use only manufacturer's replacement parts.