NEW_2601W_BethelRd__75019_50044 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-38605
Test Date: 8/27/2018
Result: Failed
Reason for Test: New
Account Name : Amazon Fullfillment Center #6
Address of Assembly : 2601 W.Bethel 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? FireLine
Manufacturer :Wilkins Model No :350BA Size :12 Serial No :41740
Location At:N.E.corner of property in vault
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:8/27/2018
Time:9:30 AM
Held at 0 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: MacArthur G Model: 845-5-0006 Serial No.: 03050223
Date Tested for Accuracy: 10/11/2017
Remarks :Unable to test.The #1 shut off valve will not close all the way
Firm Name : Fire &Life Safety America Licensed Tester : Jeremy Daugherty
Firm Address : 2821 W Euless Blvd BPAT License # : BP0017079
Firm Phone No : 972-224-9380 License Expiration Date : 09/30/2019
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.