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Click ‘Get Form’ to open it in the editor.
Begin by entering the PROJECT ID NUMBER and DATE RECEIVED at the top of the form. This information is crucial for tracking your submission.
Fill in CUSTOMER INFORMATION, including CUSTOMER NAME, CUSTOMER NUMBER, FILE NUMBER, MAILING ADDRESS, SERVICE LOCATION, and METER NUMBER. Ensure accuracy to avoid any processing delays.
Record the DATE OF TEST and TIME (A.M. or P.M.) to document when the test was conducted.
Complete the SUPPLY PRESSURE and TYPE OF ASSEMBLY fields. Specify the MANUFACTURER and MODEL of the assembly being tested.
Indicate if there are any protections from freezing and provide comments as necessary.
Proceed with filling out INITIAL TEST results for various components like RELIEF VALVE OPENED AT, AIR GAP measurements, and whether each component PASSED or FAILED.
Finally, ensure all signatures are completed at the bottom of the form for certification before submitting.

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What is the purpose of a backflow?

This serves to protect you and your home, keeping your drinking, bathing, and cleaning water safe. Backflow prevention systems are devices installed onto a pipe that only allow water to flow in one direction.

What do they do during a backflow test?

During the testing process, the plumber will verify that the check valves prevent backflow, air ports open when theyre supposed to, and relief valves open before the pressure between the check valves is too low compared to that at the inlet device. You dont need to prepare for a backflow test.

What is a backflow test report?

Customers are responsible for installing backflow prevention devices. They must have testable backflow devices tested every year.

How do I know if I need backflow testing?

Key Indicators Your Property Needs Testing If you notice sudden drops in water pressure, it might be due to a malfunctioning backflow preventer. Discoloration or an unusual taste in your water is a red flag that dirty water might contaminate your supply. Frequent, unexplained leaks can also point to backflow issues.

What happens if you dont get your backflow tested?

Ignoring backflow testing requirements can result in substantial penalties, and water providers can impose monetary fines that often increase with continued non-compliance. More seriously, water companies have the legal authority to disconnect your water service if you fail to comply with testing requirements.