Get Albemarle Service Authority

Completing the Albemarle Service Authority backflow prevention device certification/test report is essential for ensuring compliance and safety. This guide will provide you with step-by-step instructions to navigate the form effectively.

Follow the steps to complete the form efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name of the premises in the designated field. This should be the official name associated with the location of the backflow prevention device.
3. Next, provide the service address where the device is located. Ensure this is accurate, as it is critical for identification and service records.
4. Fill out your mailing address if it differs from the service address. This allows for correspondence related to the certification.
5. Enter the phone number for the premises, which will be used for any necessary follow-up or clarification.
6. In the 'Location of Device' field, specify exactly where the device is installed within the premises to facilitate inspection.
7. Indicate the type of device you are certifying by choosing the appropriate option (e.g., domestic, fire, irrigation, or other) and providing the manufacturer's name.
8. Record the model and size of the device in the designated fields to ensure accurate identification.
9. If applicable, mark whether the device is new or existing. For replacements, make sure to record the serial number of the previous device.
10. Document the line pressure at the time of the test. This is a critical measurement for understanding the device's functionality.
11. Indicate if the irrigation system's rain sensor is operational by selecting 'Yes' or 'No.' This sensor is required for proper operation.
12. Enter the actual psi values in the relevant chart fields for both the initial and final tests, including details for check valves and differential pressure relief valves.
13. Fill out the section regarding leaks and whether each valve closed tightly, noting any specific psi readings when appropriate.
14. Complete the 'Initial Test Performed By' and 'Final Test Performed By' sections with names, license numbers, and company information.
15. Ensure that the signature field is completed, certifying the accuracy of the information. Record the date when signing.
16. After completing the form, save the changes, and then you can download, print, or share the form as needed.

Complete your documents online today to streamline the process and ensure compliance.