Get Backflow Prevention Device Test Maintenance Report - Static Arvada

Filling out the Backflow Prevention Device Test Maintenance Report is essential for documenting the maintenance and testing of backflow prevention devices. This guide provides clear, step-by-step instructions to assist you in completing the form efficiently and accurately online.

Follow the steps to fill out the form correctly.

1. Press the ‘Get Form’ button to access the BACKFLOW PREVENTION DEVICE TEST MAINTENANCE REPORT and open it in the appropriate online editor.
2. Begin filling in the water supplier information along with the associated account number. Ensure that the service name, street address, city, state, and ZIP code are accurately provided.
3. Input the contact person's details including their name, title, and phone number to ensure correct communication regarding the report.
4. Complete the owner or management company/contractor section with all relevant details including their street address, city, state, and ZIP code. Also, provide the contact person's information as required.
5. Indicate whether the form is for an existing device, a new installation, or a replacement by marking the appropriate checkbox.
6. Specify the use of the device by checking all relevant options such as domestic, fire, irrigation, boiler, or process.
7. Fill in the types of containment and isolation that are applicable to your situation.
8. Provide details regarding the type, manufacturer, model, size, and serial number of the device being tested.
9. Record the installation date and the last inspection/test date, as well as the mainline pressure in PSI.
10. Document the location of the device for reference.
11. Indicate the results of the mechanical test by selecting either 'Passed' or 'Failed.' If there are failures, notify the water purveyor/authority immediately and describe the failures or repairs needed.
12. Fill in the notification details for the alarm company or fire department, including dates and times for turn off and turn on.
13. Certify that the device has been tested according to the specified procedure and provide the technician's company details, their name, certification number, expiration date, and phone number.
14. Include the technician's signature, test date, and time next to the test gauge information, along with the gauge re-certification date.
15. Obtain the signature of the owner or agent indicating verification that isolation valves are in the open position after the test is completed.
16. Finally, save changes, download, print, or share the completed form as necessary to retain a copy for future reference, ensuring compliance with the three-year retention requirement.

Complete and submit your BACKFLOW PREVENTION DEVICE TEST MAINTENANCE REPORT online today.