1225FreeportPkwy__75019_72880 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-22920
Test Date: 6/27/2019
Result: Passed
Reason for Test: Existing
Account Name : AAA Texas Headquarters
Address of Assembly : 1225 Freeport Pkwy.
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 ByPass : Model No :LF007M1QT ByPass : Size :1/2 ByPass : Serial No :08291 ByPass :
Location At:oil machine
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:6/27/2019
Time:11:20 AM
Held at 2.4 psid
Closed Tight
Leaked
Held at 1.8 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: Longhorn Model: 845-5-0011 Serial No.: 02092843
Date Tested for Accuracy: 2/18/2019
Remarks :
Firm Name : TDIndustries Licensed Tester : Rodney Palmore
Firm Address : 13850 Diplomat BPAT License # : BP0011990
Firm Phone No : 972-888-9500 License Expiration Date : 03/06/2021
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.