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620N_CoppellRd__75019_70695 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-22466 Test Date: 5/24/2019 Result: Passed Reason for Test: Existing Account Name : Lakeside at Coppell Apartments Address of Assembly : 620 N.Coppell 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 :Ames ByPass : Model No :2000B ByPass : Size :2 ByPass : Serial No :08340 ByPass : Location At:Riser room building #33 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 Type II Assembly Pressure Vacuum Breaker Spilled-Resistant Vacuum BreakerDoubleCheckValveAssembly 1st check 2nd check Relief Valve Bypass Check Air Inlet Check Valve Initial Test Date:5/24/2019 Time:1:00 PM Held at 2.6 psid Closed Tight Leaked Held at 2.4 psid Closed Tight Leaked Opened at psid Did not open Held at psid Closed Tight Leaked Opened at psid Did it fully open Yes No Held at psid Leaked Repairs andMaterialsUsed ** Test After Repair Date: Time: Held at psid Closed Tight Leaked Held at psid Closed Tight Leaked Opened at psid Held at psid Closed Tight Leaked Opened at psid Held at psid ***2nd check:numeric reading required for DCVA only Test gauge used: Potable Make: Midwest Model: 845-5 Serial No.: 08040850 Date Tested for Accuracy: 3/6/2019 Remarks : Firm Name : Metro Communication Systems Inc.Licensed Tester : Jerold Schook Firm Address : PO Box 1267 BPAT License # : BP0008669 Firm Phone No : 972-621-8700 License Expiration Date : 11/10/2019 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.