NEW_412WestLakeCt_75019_92716 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-77761
Test Date: 2/25/2020
Result: Passed
Reason for Test: Replacement
Previous Serial No.: A00611
Account Name : Current Water Customer
Address of Assembly : 412 West Lake Ct : Address Type : Residential
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 :Only on Installation What does this serve? Irrigation
Manufacturer :Febco ByPass : Model No :850 ByPass : Size :1 ByPass : Serial No :HF21927 ByPass :
Location At:Front yard by meter
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:2/25/2020
Time:11:00 AM
Held at 2.4 psid
Closed Tight
Leaked
Held at 2.6 psid
Closed Tight
Leaked
Opened at 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: Mid-West Model: 845 Serial No.: 06120628
Date Tested for Accuracy: 3/5/2019
Remarks :
Firm Name : #1American Backflow Licensed Tester : Brian Hauberg
Firm Address : 2513 Briarwood dr BPAT License # : BP0000853
Firm Phone No : 469-939-1948 License Expiration Date : 04/09/2021
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.