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Backflow Report Form - Butler County Ohio! - butlercountyohio

Backflow Report Form - Butler County Ohio! - butlercountyohio 2026

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The document is an annual test and maintenance report for backflow prevention devices issued by the Butler County Health Department. It includes sections for device details, testing results, repairs, and certifications from both the tester and the building owner or representative. The report ensures compliance with health regulations regarding backflow prevention and outlines payment instructions for the testing service.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the device address and owner/agent information in the designated fields. Ensure accuracy for proper identification.
Fill in the building name and mailing address for renewal, including city, state, and zip code. This information is crucial for future correspondence.
Document the type, manufacturer (MFR), model, and serial number of the backflow prevention device. This data helps track device specifications.
Record the test date and water supplier details. Indicate whether it’s a containment device and provide initial test results including line pressure PSI.
Complete sections for check valves, noting if they leaked or closed tight during tests. Describe any repairs made in detail.
Certify the report by filling in tester information, including signature and certification number. The building owner or representative must also sign to confirm compliance.

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Are backflow preventers required in Ohio?

Backflow preventers are required by the EPA, State law (Ohio Administrative Code 3745-95), and Ohio Plumbing Code (chapter 608) to be installed where there is a potential health or contamination threat within the consumers plumbing system.

What is a backflow test report?

Backflow testing is a process that is used to test your plumbing system to make sure that drinking water is not being contaminated by dirty water or chemicals infiltrating the water supply.

Can I do backflow testing myself?

Backflow testing requires specialized knowledge and equipment, so its best left to certified professionals. Attempting to perform the test yourself could lead to inaccurate results and potential regulatory issues.

Is backflow testing required in Ohio?

The Ohio Environmental Protection Agency requires backflow preventers to be tested every 12 months by a certified tester. Any backflow device test that does not meet the requirements shall be repaired promptly.

What happens if you dont have a backflow preventer?

If a major pressure change occurs and homes are not equipped with backflow preventers, water can flush backwards into municipal water lines, potentially contaminating the water with soap from sinks or dishwashers, human waste from toilets, chlorine from pools, fertilizers, pesticides, and any number of other dangerous

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What is a residential backflow test?

Backflow testing is a plumbing service that checks your backflow preventer device by assessing its pressure levels. When backflow is present, untreated or contaminated water can be back-siphoned into your clean water. For this reason, testing guarantees the water you use for drinking and showering is safe and sterile.

Where are backflow prevention devices required?

Many businesses must and maintain backflow prevention devices. Common examples are manufacturing facilities, process plants, medical facilities, restaurants, laboratories including school chemistry and biology labs), and buildings with boilers, fire sprinkler systems and irrigation systems.

Backflow Report Form - Butler County Ohio! - butlercountyohio 2026

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How to use or fill out Backflow Report Form - Butler County Ohio! - butlercountyohio