Get Backflow Device Form 12-28-2012 - Hamilton County Public Health

This guide provides a detailed walkthrough on filling out the Backflow Device Form 12-28-2012 for Hamilton County Public Health online. This form is crucial for ensuring the safe operation of backflow devices, and completing it accurately helps maintain public health standards.

Follow the steps to successfully complete the Backflow Device Form online.

1. Press the ‘Get Form’ button to access the Backflow Device Form online. This will open the form ready for you to complete.
2. Begin by providing the property owner's information, including their name, email address, and physical address, which should include city, state, and zip code.
3. Next, fill in the device location details. Include the street address of the device, its zip code, and a description of the device's location.
4. Enter the device serial number and the manufacturer of the device, along with the size of the water line it is connected to.
5. Indicate whether this device is part of an irrigation system by answering 'Yes' or 'No'.
6. Select the type of device from the options provided: Isolation or Containment, and specify whether the device is on a fire main.
7. Record the test date and select the device type, completing any test information required for the specified device type.
8. Document any repairs and materials used during the testing process.
9. Provide the tester's name along with their state backflow certification number, the contractor or company they represent, and their work phone number.
10. Have the tester sign the form and choose the payment type by checking the appropriate box.
11. If payment is by credit card, input the necessary card details including card number, expiration date, CVN, cardholder name and contact information.
12. Finally, review the completed form for accuracy before saving changes. You may also download, print, or share the form as needed.

Complete your Backflow Device Form online today to ensure compliance and safety!