NEW_709RockSprings_75019_133109 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-22275
Test Date: 12/28/2020
Result: Passed
Reason for Test: New
Account Name : Current Water Customer
Address of Assembly : 709 Rock Springs : 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 :Reduced Pressure Principle Frequency :Only on Installation What does this serve? Domestic
Manufacturer :Wilkins ByPass : Model No :375XL ByPass : Size :1 ByPass : Serial No :B331851 ByPass :
Location At:Garage
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:12/28/2020
Time:10:00 AM
Held at 0 psid
Closed Tight
Leaked
Held at 0 psid
Closed Tight
Leaked
Opened at 0
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 **Replaced Relief Valve Spring.
Test After Repair
Date:1/4/2021
Time:9:00 AM
Held at 10 psid
Closed Tight
Leaked
Held at 9.8
psid
Closed Tight
Leaked
Opened at 4
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.: 11161416
Date Tested for Accuracy: 2/4/2020
Remarks :12/28/20 (10:00 a.m.failed -Relief Valve did not open).
Firm Name : North Texas Backflow Licensed Tester : John Davis
Firm Address : P.O.Box 597 BPAT License # : BP0003132
Firm Phone No : 469-231-6623 License Expiration Date : 06/12/2023
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.