788CanyonDrive_75019_54417 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-22427
Test Date: 11/15/2018
Result: Passed
Reason for Test: Existing
Account Name : Wisenbaker Builder Services Inc
Address of Assembly : 788 Canyon Drive
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 :757DCDA-GV Size :8 Serial No :OE-1235
Location At:S.W.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:11/15/2018
Time:9:25 AM
Held at 3.8 psid
Closed Tight
Leaked
Held at 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: Wilkins Model: TG5 Serial No.: 05112209
Date Tested for Accuracy: 1/11/2018
Remarks :
Firm Name : Action Fire Pros Licensed Tester : John Garcia
Firm Address : 3709 S I-35 E BPAT License # : BP0015351
Firm Phone No : 800-550-2287 License Expiration Date : 07/11/2019
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.