313NDentonTapRd_75019_135347 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-22015
Test Date: 1/18/2021
Result: Passed
Reason for Test: Existing
Account Name : Walgreens #4418
Address of Assembly : 313 N Denton Tap Rd : 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? FireLine
Manufacturer :Wilkins ByPass : Model No :950 ByPass : Size :3/4 ByPass : Serial No :424274 ByPass :
Location At:Left rear 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:1/18/2021
Time:1:45 PM
Held at 2.2 psid
Closed Tight
Leaked
Held at 2.7
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: Wilkins Model: TG-5 Serial No.: 01191444
Date Tested for Accuracy: 1/14/2021
Remarks :
Firm Name : Contractors Backflow Licensed Tester : Richard Howard
Firm Address : 3461 Shiloh Rd BPAT License # : BP0008891
Firm Phone No : 469-732-1850 License Expiration Date : 03/01/2023
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.