515GreenwichLn_75019_44639 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-22944
Test Date: 5/31/2018
Result: Passed
Reason for Test: Existing
Account Name : Current Water Customer
Address of Assembly : 515 Greenwich Ln
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 :Reduced Pressure Principle Frequency :Annual What does this serve? Domestic
Manufacturer :Zurn Model No :375 Size :1 Serial No :B128743
Location At:garage
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:5/31/2018
Time:1:10 PM
Held at 9.8 psid
Closed Tight
Leaked
Held at 9.4 psid
Closed Tight
Leaked
Opened at 2.2 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.: 0146577
Date Tested for Accuracy: 1/9/2018
Remarks :
Firm Name : All STar Backflow &Plumbing LLC Licensed Tester : Steven Sellar
Firm Address : 508 Cozby Ave BPAT License # : BP0017629
Firm Phone No : 469-524*9924 License Expiration Date : 01/15/2019
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.