NEW_635AllenRd_75019_51052 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-39122
Test Date: 9/21/2018
Result: Passed
Reason for Test: New
Account Name : Current Water Customer
Address of Assembly : 635 Allen Rd
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 :Watts Model No :LF007M1QT Size :1 Serial No :082036
Location At:front flower bed
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:9/21/2018
Time:4:00 PM
Held at 2.3 psid
Closed Tight
Leaked
Held at 2.2 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: Mid-West Model: 845-5 Serial No.: 01151514
Date Tested for Accuracy: 10/20/2017
Remarks :
Firm Name : Jestis Backflow and Irrigation Service Licensed Tester : Charles Jestis
Firm Address : 3025 Oak Meadow Dr BPAT License # : BP16431
Firm Phone No : 214-535-3341 License Expiration Date : 03/17/2021
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.