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616NDentonTapRd_75019_49338 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-38295 Test Date: 8/13/2018 Result: Passed Reason for Test: Existing Account Name : Chase Bank Address of Assembly : 616 N Denton Tap 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? Irrigation Manufacturer :Watts Model No :007M1QT Size :1 Serial No :273089 Location At:SE corner in meter box by drive thru 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:8/13/2018 Time:4:15 PM Held at 2.2 psid Closed Tight Leaked Held at 2.4 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: Longhorn Model: 845 Serial No.: 02051397 Date Tested for Accuracy: 10/9/2017 Remarks : Firm Name : A &A Active Backflow Licensed Tester : John Ansley Firm Address : 1611 N IH 35E BPAT License # : BP0006162 Firm Phone No : (972)242-2229 License Expiration Date : 04/04/2020 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.