HomeMy WebLinkAboutPLIRR2023-002806Texas Commission on Environnientt] Quality
BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT
1TV" fvlhin , form nwa�f IX: owl' h:?zkt tctvkt A ,i -j ;-ojcLlk�j 06, in;41 we"t 1s- mAnnimcdt, I I fv- I wmersub )wr fof Wkon1kca1- in v- * 4'-
NIAM U, Of~ PWSa q4ppvirLe,. TX
PWS tr)#:
PWS SIAILING ADDUSS., 200 S Main Street Grapevine, TX 76051
WS CONTAC-r PERSON: Permits
ADDRESS OF SERV ICE: 4296 Hazy Moadow 4296 Hazy Meadow Grapevine, TX 76051
Thc back1low prevemion as.wmbly detailed below has been tcsud rind maintained as required by cormirismon rewgulmions
and is certified to ix- oP; rafin! wiihin acce�-table j,!ranleters.
TYPE OF BACKFLOW PREVENTIONASS F.MBLY (BPAY:
Reduced Pressure Principle (RPBA) Reduced Pressure Pr-inc iple-1),etector (RPBA-D) TyW If 0
Double Check Valve (DCVA) E) Double Check -Detector (DCVA-D) I ype. 110
ProsstireVztctiuiiiBre-,iker(PVB) Spill-Resislaiii Pressure Vacuum Breaker (SVB)
Manul'acturer: rain: Wilkins rtyp;ls": S i -/x: Win: J" By;Yass.-
Viode-1 Number: milin:350
Bypass- BPAJ,ocajjjtni- At Meter in front offence left of driveway
Serial Nomber M-1i'vAJAM0361 B)Tass: BPA Servim Irrigation
it # Unk
Re,is(ln fil- test New 0 EIx"itin": 0 Replacement 0 OWMWO/Scri< Unk
Is the assembly installed in accordance wilh inarinfacturer recommendation-'s anittor locul C(XICS" 91 Yes 0 No
IN thcas%einbly instakd on a tion-1w.nable walersupply fauxifiaq)? 0 Ye,, R1 No
Type It
Roduced Pressure Primiple Assembly (RPBA ) Assembly PVB & SVB
PASS 0 DC VA
Re
Inlet lief'Valve Byposs Check Aii Ctro.ck Valve
FA I L 11 1 CKck 273 CheC
lnirfal'reiit lie id A 2.8 1 leld at 2-3
---- psid pid Open"I W tic, ld �'Q -PN�id 11"id 410d al
I
'Date'. 08-15-23 'id _h, C] :Didnotqwn Ps i d
P,
�Time:9,17 AM Did thit 0 Did it fiffly kqxn -akal
Ulaked I A: ak ked Leak-W
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p D 0)
[Rcpairs and Main:
Used"
4esl After Jieldal sid tleld.lt psid opcwA at
P psid P\id tic W al
p4d
)It 0 psal
Dare - 0
Jim.-
?rK1 check: numeric rcaoiwl,N, Ored I'm DCVA unl,,
Differential pressure gauge used:
Make/Ntimlel. Midwest 845-5 SN: V8132518 Dut,� rested t*or;icctiml.
Cumpany Nanie: 4-Real Testing Licefi%ed Tester Name
WrinVf' Marc Bprry
Ctmijukny Address- 9904 Sunrise Cv Licemseri'Vester Name (Signature):
Oak Point, TX 75068
Compuny Phone #-. 214-597-1760 BPAT Liacenm.- 4 BPOO19735
Licen.se Expiration Daie. 06-24-2-6
The above is certified to be trm at The finir of Iestirig.
TE'STRE-CORDS MUST 13(i KUPT FOR AT LEAST THREE YUIARS t30'rA(r'§2'X1Ai B)f
*4 USE ONLY MANUFACTURER'S REPLACEMENTPARTS
TCEQ-207W (Revision 04-04 -2019) hoe I of I
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