Denton Tap 1A-LR051216 (2)CHECK ONE:
IRRIGATION DOMESTIC
FIRELINE
BACKFLOW PREVENTION ASSF. fl~LY TF. ST AND MAINr~:NANCE REPORT
NAME OF PWS: ~
Manufacturer
Mod~l Number
Serial Number
TYPE OF ASSEMBLY
t2 Pressure Vacuum Br~ak~
Atmosph~r~ Vacuum Break~
sm
REDUCED PRESSURE PRINCIPLE ASSEM~BLY PRESSURE VACUUM BREAKER
Double Check Valve A~sembly
1~ Check t 2nd Check Relief Va]Ye .A. ir lnb,t C'h~Ir V~lve
Initial Test DC-Closed 'l. ~~,Clos~losed Tighte" ~Opened at Opened at psid
Ti_~fit ~ Lcak~ ~ psid psid
RI~- psid l, 9
Leaked a Did not Op~t~ = ~ed a
and
Materials
Used
T~t ~ DC-Clos~ Closed Tight ~ Opened at Opm~ at psid
R~air Ti~t ~2 psid psid
RP psid
¢~rt T~er No. ~'7.. ~
Date last accuracy tested