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Coppell CC 1B1-LR010917 (3)
CIIECK ONE: IRRIGATION BACKFLC)W PREVENTION ASSEMBLY TF. ST AND MAINI~IANCE REIK)RT NAME OF PWg: PWS I.D. # LOCATION OF SERVICE: TYPE OF ASSEMBLY ~ R~_,_ _,~_ P~ssu~ Pmxipl¢ m ~ Doubl~ Check Vg~ a Pressure Vw~ Breaker Aunosphere Vacuum REDUCED PRESSURE PRINCIPLE ASSEMI~LY PRESSURE VACUUM BREAKER Double Check Valve AS~mhly // Ist Check 2nd Check Re'Valve A~r Inlet / Vxlve RP-~sid Ti~ ~ p~d ~ ~d , Date last accuracy tested White - Customer~ Copy Yellow - City Copy Pink - Tester*s Copy