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185W_ParkwayBlvd__75019_85460 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-36143 Test Date: 12/17/2019 Result: Passed Reason for Test: Existing Account Name : CISD Coppell High School Address of Assembly : 185 W.Parkway 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 :909QT ByPass : Size :3/4 ByPass : Serial No :254710 ByPass : Location At:West Mezz N.CK. 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:12/17/2019 Time:7:15 AM Held at 7.9 psid Closed Tight Leaked Held at psid Closed Tight Leaked Opened at 2 psid Did not open Held at psid Closed Tight Leaked Opened at psid Did not open 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 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: Combraco Model: 40 Serial No.: 258000 Date Tested for Accuracy: 9/24/2019 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.