1110NorthpointDr__75019_123314 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-28067
Test Date: 10/23/2020
Result: Failed
Reason for Test: Existing
Account Name : Primera Coppell Properties
Address of Assembly : 1110 Northpoint Dr. : 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-Detector Assembly Frequency :Annual What does this serve? FireLine
Manufacturer :Watts ByPass : Model No :709 ByPass : Size :8 ByPass : Serial No :112583 ByPass :
Location At:se corner vault
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:10/23/2020
Time:12:50 PM
Held at 0 psid
Closed Tight
Leaked
Held at 0 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.: 10160753
Date Tested for Accuracy: 9/22/2020
Remarks :Disregard test results above.Unable to complete test because water leaking through OS&Y packing.Need to re-pack valves and
re-test.
Firm Name : Action Fire Pros Licensed Tester : Gaines Blevins
Firm Address : 3709 S I-35 E BPAT License # : BP0016417
Firm Phone No : 800-550-2287 License Expiration Date : 03/13/2021
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.