NEW_1650PointWestBlvd__75019_75799 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-47551
Test Date: 8/15/2019
Result: Passed
Reason for Test: New
Account Name : Tru by Hilton
Address of Assembly : 1650 Point West Blvd.
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 :Watts ByPass : Model No :LF009M2 ByPass : Size :1 1/2 ByPass : Serial No :038483 ByPass :
Location At:By swimming pool
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:8/15/2019
Time:2:17 PM
Held at 0 psid
Closed Tight
Leaked
Held at 0 psid
Closed Tight
Leaked
Opened at 0
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 **Removed debris from CV 1
Test After Repair
Date:8/15/2019
Time:2:30 PM
Held at 12.7 psid
Closed Tight
Leaked
Held at 12.6
psid
Closed Tight
Leaked
Opened at 3.4
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: Conbraco Model: 40200TK5 Serial No.: 356706
Date Tested for Accuracy: 1/2/2019
Remarks :Device discharging at RV
Firm Name : BluFenix Fire Solutions Licensed Tester : Roger Cartwright
Firm Address : 2022 Kendolph Drive BPAT License # : BP0013313
Firm Phone No : 940-206-8427 License Expiration Date : 07/31/2021
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.