531W_BethelRoad_75019_63212 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-21319
Test Date: 1/25/2019
Result: Passed
Reason for Test: Existing
Account Name : Founders'Crossing,LLC
Address of Assembly : 531 W.Bethel Road
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? Domestic
Manufacturer :Watts Model No :LF007M1QT Size :1 Serial No :031564
Location At:Meter at S.W.corner of property
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:1/25/2019
Time:11:30 AM
Held at 0 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 **Replaced Check 1.
Test After Repair
Date:1/25/2019
Time:12:00 PM
Held at 1.6 psid
Closed Tight
Leaked
Held at 2 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: 10/8/2018
Remarks :Check 1 failed at 0.0
Firm Name : Classic Backflow,LLC 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.