508WranglerDr#100_75019_133356 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-23042
Test Date: 1/5/2021
Result: Passed
Reason for Test: Existing
Account Name : ZS Parma Inc
Address of Assembly : 508 Wrangler Dr #100 : 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? Irrigation
Manufacturer :Watts ByPass : Model No :LF009M3QT ByPass : Size :3/4 ByPass : Serial No :85616 ByPass :
Location At:warehouse at storage tanks
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:1/5/2021
Time:10:16 AM
Held at 8.5 psid
Closed Tight
Leaked
Held at 8.4
psid
Closed Tight
Leaked
Opened at 4.1
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: Apollo Model: 40-200-TK5U Serial No.: 05141063
Date Tested for Accuracy: 7/11/2020
Remarks :
Firm Name : Allied Flow Specialists,Inc.Licensed Tester : Christopher Coffman
Firm Address : PO Box 1150 BPAT License # : BP0016261
Firm Phone No : 972-723-5535 License Expiration Date : 11/25/2023
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.