BACKFLOW PREVENTION ASSEMBLY TEST REPORT CITY OF BELLEVUE Water Quality Box 90012 Bellevue, WA 98009 (425) 452-5208 FAX (425) 452-7116 NOTE: all new backflow assemblies installed must be tested prior.
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How to fill out the Backflow Test Form - City Of Bellevue online
Completing the Backflow Test Form for the City of Bellevue is essential for maintaining water quality and ensuring compliance with local regulations. This guide provides clear and supportive instructions to help users navigate the form effectively, whether they are familiar with the process or not.
Follow the steps to complete the Backflow Test Form online.
- Click ‘Get Form’ button to begin the process of accessing the Backflow Test Form and open it in your preferred document editor.
- Enter the account number in the designated field at the top of the form.
- Provide the name of the premise in the space provided and indicate if it is a commercial or residential property by checking the appropriate box.
- Input the service address with the city and ZIP code.
- Fill in the contact person's name and provide their phone number and fax number, if applicable.
- Specify the location of the backflow assembly and downstream process by checking the corresponding box for DCVA, RPBA, PVBA, or other.
- Indicate whether this is for a new installation, existing assembly, or replacement by checking the appropriate box.
- List the make and model of the assembly, including the serial number.
- Record the results of the initial test, noting if the proper installation was confirmed by selecting yes or no.
- Detail the air inlet measurements and whether the assembly passed or failed the test.
- Document any repairs done, including if parts need to be cleaned, replaced, or if the assembly did not open.
- For the air gap inspection, confirm if the minimum air gap separation is provided by marking yes or no.
- Provide a detector meter reading, remarks, and line pressure in the specified fields.
- Complete the signature section by including the tester's name, certification number, and date, and ensure final tests are recorded.
- After filling in all necessary fields, save your changes, download the completed form, print for your records, or share it as required.
Complete your Backflow Test Form online today to ensure compliance and proper documentation.
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Get answers to your most pressing questions about US Legal Forms API.
How do I know if I have a backflow prevention device?
You can check to see if you have a backflow prevention assembly by looking at where water enters your property (usually in a basement by the water heater, a crawl space, or in a mechanical room).
What is a backflow device and where is it located?
To ensure it is working properly to protect home and public drinking water systems, the law mandates an annual test. Where is my irrigation backflow device located? Typically irrigation backflow units are located outside near your home or business water meter in a plastic box, usually green or black in color.
What is a backflow charge?
Backflow Fee DSRSD charges a bimonthly administration fee to customers that are required to install backflow prevention devices. This fee funds the District's efforts to comply with the Department of Public Health's requirements to protect the public water system from backflow contaminants.
Where is the backflow prevention device installed?
Backflow prevention systems are devices installed onto a pipe that only allow water to flow in one direction. Think of it as a one-way gate that allows water from the city's public water supply to flow into your home's piping but stops water if and when it ever tries to flow backwards into the main water supply.
Where is the backflow valve located?
If you aren't sure, take a look around your basement backwater valves are usually located in the floor and have a cover that can easily be removed for maintenance. The cover itself is likely round, but there may also be a rectangular panel on top. If you have a sump pump, the backwater valve is likely close by.
How are backflow preventers tested?
During backflow testing, a certified plumber will open and close the valves of the backflow prevention device or assembly to make sure it is functioning as it should. The plumber will assess the valves for leakage, gauge movement and other telltale indicators of a malfunction.
What does a backflow device look like?
Double check backflow preventers consist of two check valves, four test ports, and two shut-offs and are commonly found in green rectangular irrigation boxes at ground level. These are also occasionally installed in crawl spaces, garages, and unfinished basements.
Where is backflow valve located?
Backwater valves are usually located in the floor of your basement. If you know where to find your sump pump, the backwater valve is probably nearby. There may be a rectangular panel on top, but often the compartment itself is clear so that you can see inside relatively easily and the round cap can be removed.
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