NEW_1322CrestsideDr__75019_53986 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-40163
Test Date: 11/2/2018
Result: Failed
Reason for Test: New
Account Name : Mastec,Nestle Waters
Address of Assembly : 1322 Crestside Dr.
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 Assembly Frequency :Annual What does this serve? FireLine
Manufacturer :Watts Model No :774DCDA Size :8 Serial No :6769847
Location At:In vault eastside of bldg.by rear entry
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:11/2/2018
Time:11:00 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: Wilkins Model: BFTG-5 Serial No.: 03030604
Date Tested for Accuracy: 4/13/2018
Remarks :OS&Y packings need to be replaced,could not shut off valve #1 or #2 completely to do the test.
Firm Name : SFS Security Fire Systems Licensed Tester : Mark Cantu
Firm Address : 196 Freeport Parkway BPAT License # : BP0008602
Firm Phone No : 469-763-1681 License Expiration Date : 10/12/2019
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.