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730NDentonTapRd_75019_49804 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-22019 Test Date: 8/30/2018 Result: Passed Reason for Test: Existing Account Name : Whataburger #1010 Address of Assembly : 730 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 :Reduced Pressure Principle Frequency :Annual What does this serve? Domestic Manufacturer :Watts Model No :009M3QT Size :3/4 Serial No :304243 Location At:By mutiplex 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:8/30/2018 Time:10:30 AM Held at 7.9 psid Closed Tight Leaked Held at 7.5 psid Closed Tight Leaked Opened at 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: Conbarco Model: 40-200-TK5 Serial No.: 372447 Date Tested for Accuracy: 11/30/2017 Remarks : Firm Name : Prime Landscape Services Licensed Tester : Rigoberto Hernandez Firm Address : PO BOX 171626 BPAT License # : BP0010421 Firm Phone No : 817-461-4000 License Expiration Date : 03/30/2019 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.