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Coppell CC 1B1-LR010917 (5)
CtlECK ONE: IRRIGATION DOMIL,~'rlC FIRELINE BACKI~W PREVENTION A~'~d~IBLY TEST AND MAINTENANCE REPORT NAME OF PWS: PWS LD. # TYPE OF ASSEMBLY P, zdu~ Pr~ssur~ Pri~ipl¢ a Pr~sur~ Vaom,- Br~l~r Double ~ V~ ~ A~ V~ B~ REDUCED PRESSURE PRINCII~LE ASSEMBLY PRESSURE VACUUM BREA~R Double Check Vslve Ass~hly / ls~ Check :2nd Check R~lid ~ve Air Ini~ Check V~e ~ Ti!ill 3.6. 'll~, Leaked ~.O opsid~' ~=-~P'~ RP-~sid · -' Leaked O Didn'o~0~ o Leak~ Ci Mlmrial~ Test ~ DC-Closed Closed Tight o Opmcdat/ Op~zd at psid P.,~pair Tight []_~sid psid FirmAdg~s~O~ ~¢-~'~ .~ Cert. Test~rNo. t~ Date ~/2~1~/ Date last accurac, tested White - Customer~ Cogy Yellow - Cit~ Cogy Pink - Testers Cogy