NEW_630Westhaven_75019_38233 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-28783
Test Date: 1/8/2018
Result: Passed
Reason for Test: New
Account Name : Current Water Customer
Address of Assembly : 630 Westhaven
Address Type : Residential
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 :Only on Installation What does this serve? Irrigation
Manufacturer :Wilkins Model No :350 Size :3/4 Serial No :A688754
Location At:Front Yard
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:1/8/2018
Time:4:04 PM
Held at 2.3 psid
Closed Tight
Leaked
Held at 2 psid
Closed Tight
Leaked
Opened at 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: Conbraco Model: 40200-TKU Serial No.: 06041697
Date Tested for Accuracy: 8/23/2017
Remarks :
Firm Name : SB Irrigation,Inc.Licensed Tester : Michael Burke
Firm Address : 6622 Eastview Drive BPAT License # : BP0008590
Firm Phone No : 970-980-3734 License Expiration Date : 10/07/2019
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.