Backflow test form pdf 2026

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  1. Click ‘Get Form’ to open the backflow test form in the editor.
  2. Begin by entering the 'Date' at the top of the form. This is essential for record-keeping.
  3. Fill in the 'Account Name/Business Name' and 'Account Address' fields to identify the service location.
  4. Input the 'Account Number' and 'Meter Number' for accurate tracking of your backflow device.
  5. Complete the device details by filling in 'Device Name', 'Model Number', 'Serial Number', and 'Size'.
  6. Specify the 'Device Location' clearly to ensure proper identification during inspections.
  7. In the testing section, mark whether each component is ‘Leaked’ or ‘Closed Tight’ based on your findings.
  8. After completing all sections, ensure you sign as the tester and provide your certification number and company details.

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Test water quality. An easy way to tell if your backflow preventer isn't working is simply by testing the quality of your water. Any contaminants, foul odors, or unhealthy aspects of your water could be from a failed backflow preventer and contamination in your water supply.
They must not only be tested annually, but rebuilt every five years. If not, there could be serious harmful backflow. If you discover anything amiss in the testing of the backflow preventer, it is a good idea to handle it right then.
Open the high "A" valve. Slowly open the low "B" valve no more than ¼ turn. Hold the valve at this position and observe the gauge reading at the first moment the first discharge is noted from the relief valve. Record this as the opening differential pressure of the relief valve on the test report form.

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They must not only be tested annually, but rebuilt every five years. If not, there could be serious harmful backflow. If you discover anything amiss in the testing of the backflow preventer, it is a good idea to handle it right then.
Preparing For A Backflow Test Prepare your property for a water supply shut-off. Authorities should also be notified if the shut-off may affect fire fighting devices. Record the water system's initial conditions and specifications, including connections, assemblies, installations, and area-related details.
There are two types of backflow: back-pressure and back-siphonage.
The testing process involves using valves on the backflow testing device, known as gate and relief valves. Essentially the plumber will be closing valves and checking for changes in gauge movement, water leaks and other clear signs. There are specific criteria that needs to be met during the testing process.
There are two types of backflow\u2013back pressure and back siphonage.

sample backflow test report form