Backflow Assembly Test Report - Township of Langley 2026

1. Click ‘Get Form’ to open the Backflow Assembly Test Report in the editor.
2. Begin by entering the 'Premises name' and 'Test Date' at the top of the form. Ensure that you also fill in the 'Postal code' and 'Premises address' for accurate identification.
3. In the 'Owner’s phone' and 'Owner’s email' fields, provide your contact information. This is essential for any follow-up communication regarding the test results.
4. Select the type of protection by checking either 'Domestic' or 'Sprinkler'. Then, indicate the size of the assembly.
5. For each check valve, mark whether it is 'Closed tight' or if it has 'Leaked'. Fill in the corresponding psi values as required.
6. Complete sections for relief valves, air inlet valves, and air gap inspections by providing necessary psi readings and passing/failing statuses.
7. Finally, ensure that both the certified tester's signature and owner's signature are included before submitting your completed form via email to backflow@tol.ca.

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