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Coppell CC 1B1-LR010917 (2)
IRRIGATION DOME~qC ~ FIRELINE BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT IqAMB OF PWS: PWS I.D. # Mamtfacua~ Model Number S~rial Number TYPE OF ASSEMBLY m Pr~ssur~ Valuta Br~l~r ~ Am~osph~r~ Vacuum Breaker $iz~ ~ ~a REDUCED PRESSURE PRINCIPLE ASSEMBLY i PRESS~ VACUUM BREAKER Double Check Vslve A.~hly ~e Ist Check 2nd Check Relief Air hget ~, alve Initial Trot DC-Closed ,Closed Ti,.!~ ~ ~Opcncd a~ ~ psid RP- psid T~t~ DC.C~i~ Qo~lTi~t ~ Op~ at Ope~l~t p~l l~p~ir Ti~t m p~id psid Cert. Tear No. ~)~ q Da~e ~''/~ ~ f Date last accuracy tested ~-~ ~-QI White - Customer~ Cogy Yellow - City Copy Pink - Testers Copy