1303WranglerCircle_75019_61676 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-21253
Test Date: 12/31/2018
Result: Passed
Reason for Test: Existing
Account Name : Coppell ISD
Address of Assembly : 1303 Wrangler Circle
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 :Reduced Pressure Principle Frequency :Annual What does this serve? Domestic
Manufacturer :Wilkins Model No :375 Size :2 1/2 Serial No :L48179
Location At:West Mezz /High School /185 W.Parkway
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:12/31/2018
Time:8:00 AM
Held at 6.7 psid
Closed Tight
Leaked
Held at psid
Closed Tight
Leaked
Opened at 2 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: Combraco Model: 40 Serial No.: 258000
Date Tested for Accuracy: 10/4/2018
Remarks :
Firm Name : Coppell ISD Licensed Tester : David Bailey
Firm Address : 1303 Wrangler Cir BPAT License # : BP0006758
Firm Phone No : 214-496-8040 License Expiration Date : 02/07/2020
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.