800Bethel_75019_42543 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-22604
Test Date: 4/19/2018
Result: Failed
Reason for Test: Existing
Account Name : Current Water Customer
Address of Assembly : 800 Bethel
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 :774 Size :8 Serial No :108717
Location At:vault in front
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:4/19/2018
Time:9:30 AM
Held at 2.7 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 **
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: 40-200-TKP Serial No.: 331768
Date Tested for Accuracy: 4/21/2017
Remarks :#CHECK FAILED,BUT THE BACKFLOW LID HAS RUSTED BOLTS AND NUTS,IT WILL NEED TO BE REPLACED ,WILL HAVE TO
CUT OFF BOLTS
Firm Name : American Fire Protection Group Licensed Tester : James Enochs
Firm Address : 10575 Vista Park Rd BPAT License # : BP0010026
Firm Phone No : 214-283-2150 License Expiration Date : 09/06/2018
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.