Doh 1013-2026

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The document is a report template from the New York State Department of Health for testing and maintenance of backflow prevention devices. It includes sections for initial and annual tests, device information, repair details, and certifications by certified testers and property owners. The form must be completed for each device tested and submitted to relevant health department representatives and water suppliers within 30 days.

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Click ‘Get Form’ to open the doh 1013 in the editor.
Begin by indicating the test year and whether this is an initial or annual test in Part A.
Fill in the public water supply name, account number, and county. For New York City tests, include block and lot information.
Provide the facility name, address, and specific location of the backflow prevention device.
Complete the device information section with details such as manufacturer, type (RPZ or DCV), model, size, and serial number.
In the 'Test Before Repair' section, indicate if check valve #1 and #2 leaked or closed tight. Record line pressure and test date.
Describe any repairs made along with materials used and provide the name and license number of the repairer.
Complete the final test section if repairs were made, including water meter number and type of service.
Fill out remarks for any deficiencies observed during testing.
Certify that all data is correct by printing your name, signing, and providing your certification number and expiration date.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How often do backflow preventers need to be tested?

Under Section 64764 of the regulations, backflow prevention devices must be tested annually by certified testers.

What does backflow detected mean?

Backflow is the undesirable flow reversal of water, liquids, gases or other substances into the City of Raleigh Public Water Supply. Backflow can occur when water pressure in the distribution system drops relative to a service line.

What happens if a backflow test fails?

If your backflow preventer fails the test, it needs to be cleaned or repaired and in some cases it may need to be completely replaced and a successful re-test performed.

What does it mean to fail a backflow test?

If your backflow preventer fails the test, it needs to be cleaned or repaired and in some cases it may need to be completely replaced and a successful re-test performed. These backflow devices fail at a rate of 10-15% after one year.

What does backflow testing mean?

Backflow Preventer Your houses water supply can become contaminated if backflow isnt prevented. Replacement of the backflow preventer, which can cost between $280 and $1,550, is frequently the most expensive repair. This includes the price of labor, replacing the backflow preventer, and testing the system.

doh 1013 form

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What happens if you dont get your backflow tested?

If you dont have your backflow tested annually, as required by the Department of Health, your water purveyor will eventually take action to protect the health of their water system. Each water purveyor has different policies, but typically they impose fees once the test is severely delinquent.

How much does it cost to repair a backflow valve?

There are two types of backflow: back pressure and back-siphonage. Back pressure occurs when water pressure from a non-potable source exceeds your water supply. This causes the flow to reverse. Back siphonage occurs when there is a loss of pressure in your supply line that causes contamination to be in.