531W_BethelRoad_75019_135473 BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT
Name of PWS:Coppell
PWS I.D.:TX0570040
Address:816 S.Coppell Road
Coppell,Texas 75019
Phone:972-462-5150
Contact Person:Jerry Davis
Catalog No: TXTCOP-21319
Test Date: 1/17/2021
Result: Passed
Reason for Test: Existing
Account Name : Founders'Crossing,LLC
Address of Assembly : 531 W.Bethel Road : 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 ByPass : Serial No :031564 ByPass :
Location At:Meter at S.W.corner of property
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:1/17/2021
Time:2:00 PM
Held at 2 psid
Closed Tight
Leaked
Held at 2.2
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 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: Mid-West Model: 845-5 Serial No.: 01151514
Date Tested for Accuracy: 8/10/2020
Remarks :
Firm Name : Classic Backflow,LLC Licensed Tester : Charles Jestis
Firm Address : 3025 Oak Meadow Dr BPAT License # : BP16431
Firm Phone No : (214)535-3341 License Expiration Date : 03/17/2021
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.