Get Cross Connection Test Form - Citizens Energy Group

This guide will assist you in completing the Cross Connection Test Form for Citizens Energy Group online. It provides straightforward steps to ensure that you fill out each section accurately and efficiently.

Follow the steps to complete the Cross Connection Test Form.

1. Click ‘Get Form’ button to access the Cross Connection Test Form and open it for editing.
2. Fill in the test due date, facility name, service address, and mailing address. Ensure that all addresses reflect the current information for effective communication.
3. Provide the owner's name and the manager’s name, along with their respective company title and mailing address, if applicable.
4. Specify the date of the test, and include the contractor’s name and contact information for any future follow-ups.
5. Indicate the type of backflow prevention assembly being tested. Select from the available options, e.g., DC, RP, DCDA (detector), RPDA (detector), PVB, SVB.
6. Document the height of the assembly off the floor, ensuring the dimensions are recorded accurately.
7. Fill in the supply pressure and indicate whether the air gap measurements meet standards.
8. Select whether this is a new installation, and fill in details regarding protection measures taken at the inlet.
9. Record the serial number of the assembly and previous assembly serial number, if applicable.
10. Indicate whether the test for flooding and freezing has been performed, and document the results as 'pass' or 'fail'.
11. Complete the initial and final tests by providing the pressure readings at various points, noting any that have failed and may require repair.
12. Fill out the details for the test gauge including maker, model, calibration date, and the certification number.
13. Sign and print your name, along with the date, and ensure the owner or owner's representative does the same.
14. Once all sections are filled out, save the changes, and choose to download, print, or share the completed form as needed.

Complete your Cross Connection Test Form online today for efficient processing.