NEW_610OakGroveLn__75019_49416 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-38315
Test Date: 8/22/2018
Result: Passed
Reason for Test: New
Account Name : Current Water Customer
Address of Assembly : 610 Oak Grove 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 :Double Check Valve Frequency :Only on Installation What does this serve? Irrigation
Manufacturer :Wilkins Model No :350 Size :1 Serial No :A718086
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
Spilled-Resistant Vacuum BreakerDoubleCheckValveAssembly
1st check 2nd check Relief Valve Air Inlet Check Valve
Initial Test
Date:8/22/2018
Time:4:29 PM
Held at 2.8 psid
Closed Tight
Leaked
Held at 2.8 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: Apollo Model: 40200TK5U Serial No.: 03100664
Date Tested for Accuracy: 4/16/2018
Remarks :
Firm Name : Lakeside Irrigation Licensed Tester : John Travis
Firm Address : 504 Willow Springs BPAT License # : BP0014792
Firm Phone No : 972-722-8020 License Expiration Date : 09/21/2021
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.