TC Bank-CS050907COPPELL
Water
Name
Address
Cross Street
Location
Description
WOWA-05-4187
Cory (H) 972-877-7820
s.l.i. (w)
654 N Denton Tap
Unknown
Town Center Bank: Today, 9/7/05 @ 1:00 pm
Department of Public Works
Initial Date: September 07, 2005
Final Date:
Created By:
Walk Throu~]h
] Left Door Knocker
[~'"'"Spo ke to -I:~ei,JerTt--
Called Resident
Noti~ Water Billing
Office Comments
Assigned To
Danny Hightower
Old Meter #
Reading
New Meter #
Reading
Personnel Assigned Hours Quantit
Parts - Equipment Used
P.O. Box 9478 - 8'16 S. Coppell Rd - Coppell, TX 75019 - Phone (972) 462-5150 - Fax (972) 462-5155
Field Comments: ,~z~O ~ ~ ~'~-~ x~/~4- .~,~C~zc; ~/~//~ ~ ~ ~[~
Signature: - Date: ~-~ Time: /,'~ ~
¢tIECK ONE:
IRRIGATION
DOMESTIC ~ FIRELINE
BACKFLOW PREVENTION .ag$S~LY TEST AND MAIIN ~ ~:NANCIi: REPORT
NAME OF PWS:
PWS I.D. #
The backflow prevention assembly detailed below has be~n tested and maintained as required by TCEQ
regulations and is certified to be operating within acceptable parameters.
TYPE OF ASSEMBLY
~/~-- Rraic=d Pressur~ Principle
Double Cl~ck Valve
M~N~b~ ~-~ } ~a~At
Pressur~ Vacuum Br~al~r
Atmosphere Vacuum Br~ 'akin'
REDUCED PRESSURE PRINCIPLE ASSEMBLY PRESSURE VACUUM BREAKER
Double Check Valve Assembly
1st Check I 2nd Check Relief Valve Air Inlet Check Valve
Imual T~ DC-Closed .Closed Tight ~' Ope"ed at Opcued at psid
Tight ~2..c-~ ~' L~.~ked c~ psid psid
RP- psid "Z-
Leaked a Did uot Ope"
Maumals
Used
T~ ~ DC-Closed Closed Tight a Ope-ed ai ~ed at psid
Repair Tight a psid psid
RP psid
The above is c='dried to be uue.
Gauge# OOK~'&1A
Date last accuracy tested
White - Customer's Copy Yellow - City Copy Pink - Tester~ Copy
' CtlECK ONE:
IRRIGATION
DOMESTIC FIRELINE
BACKI~OW PREVENTION ASSF-.M~LY TEST AND MAINTENANCE REPORT
NAM~ OF PWS:
PWS I.D. 18
LOCATION OF SERVICE: }b~ Ce~.~-~.~ [~.~1{ ~c~ PO. {).~% faF
The backflow prevention assembly detailed below has been tested and maintained as required by TCEQ
regulations and is certified to be operating within acceptable parameters.
TYPE OF ASSEMBLY
~ R~luc~ Pressure Principl~ m
Double Ch~ck Valve
Manufacturer IC ~l:>e o Siz. c
Model Number ~ ~ ~ Located At
Pmssur~ Vacuum Bmak~'
Atmosph~r: Vacuum Brr. ak~r
REDUCED PRESSURE PRINCIPLE ASSEM]{LY PRESSURE VACUUM BREAKER
Double Check Valve Assembly
l~t Che~k { 2nd Check Relief V~ve Air Inlet Check Valve
Iuiual T~-'t DC-Clos~ Clos~ Tight c~ ~Opcued at Opeu~I at psid
Tight '7_. O_ cID "l~cakcd c~ psid psid
RY- psid Z.. ]
Lr. akcd C~ Did not Opm
and
Materials
Us~l
Test Attcr DC-Closed Closed Tight O Opcn~ ac ! Opcn~l at psid
R~'pair 'Tight [] psid psid
RY psid
Thc above is ccrdfied to be true.
C~ T~-u~ No. ~P ¢'~-X ~- Dm'7~l I -~'
Date last accuracy tested ~-- '~- 0 ~5~
White - Customer's Copy Yellow - City Copy Pink - Tester's Copy