Henry County Water Authority Backflow Test Report: Fill out & sign online

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How to use or fill out the Assembly Test Data and Maintenance Report online

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Click ‘Get Form’ to open it in the editor.
Begin by entering the 'Account Contact Name and Number' at the top of the form. This ensures that all communications are directed to the right person.
Fill in the 'Account Name' and 'Mailing Address' fields accurately, as this information is crucial for record-keeping.
Provide your 'HCWA Account No' and 'Service Address'. These identifiers help streamline service requests.
Complete the sections for 'Manufacturer', 'Type of Assembly', and 'Installation Date'. This data is essential for maintenance tracking.
In the testing section, indicate the 'Test Date', select whether it's an Initial, Annual, or Other test, and fill in relevant details about check valves and repairs as needed.
Finally, ensure you sign off on the certification statement at the bottom of the form to validate your entries before submission.

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Versions	Form popularity	Fillable & printable
2018	4.6 Satisfied (52 Votes)
2015	4.2 Satisfied (31 Votes)

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