1711EBeltlineRd_75019_41230 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-22357
Test Date: 3/20/2018
Result: Passed
Reason for Test: Existing
Account Name : Justice Benefits Inc
Address of Assembly : 1711 E Beltline 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 :Double Check Valve Frequency :Annual What does this serve? FireLine
Manufacturer :Watts Model No :757 DCDA Size :8 Serial No :ND-0885
Location At:S.W.Corner in vault
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
Spilled-Resistant Vacuum BreakerDoubleCheckValveAssembly
1st check 2nd check Relief Valve Air Inlet Check Valve
Initial Test
Date:3/20/2018
Time:4:00 PM
Held at 2 psid
Closed Tight
Leaked
Held at 0 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 **Replaced the rubbers on Check 2
Test After Repair
Date:3/20/2018
Time:5:00 PM
Held at 2 psid
Closed Tight
Leaked
Held at 2.6 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: midwest Model: 845-5 Serial No.: 04162733
Date Tested for Accuracy: 3/13/2018
Remarks :Replaced rubbers on 2nd check
Firm Name : AA Atlas Fire Inspections Licensed Tester : Bryan Elliott
Firm Address : 2401 Callender Rd.,Ste.103 BPAT License # : BP0001023
Firm Phone No : 817-821-3816 License Expiration Date : 08/07/2020
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.