Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the premises number in the designated field at the top of the form. This identifier is crucial for locating your specific location in the Greenville Utilities database.
3. Next, accurately provide the location of the assembly in the corresponding field, ensuring that the description is clear and precise to facilitate easy identification.
4. Fill in the type, manufacturer, model, size, and serial number of the backflow prevention assembly. This information is important for quality assurance and tracking purposes.
5. You will need to enter the name of the owner in the specified field, followed by their mailing address, city, state, and zip code. Ensure this information is up-to-date.
6. Provide the tester's name and certification number, as well as the date and time of the test. This identifies the authorized individual responsible for the maintenance.
7. Indicate the type of service (new test or recertification test) in the allotted space.
8. Record the line pressure and the test kit information, including the serial number and calibration date, in the respective fields.
9. You will then assess each check valve and the relief valve. Mark whether they leaked or closed tightly, and document the differential pressure across each check valve.
10. Complete the pressure vacuum breaker details, indicating if the air inlet opened and at what pressure, alongside checking the status of the check valve and any necessary cleaning or replacement notes.
11. Fill out any additional details regarding shut-off valves, including whether they leaked or closed tightly, and provide associated buffer pressure readings.
12. After entering all necessary information, review your entries for accuracy before signing to confirm the data is correct. Include the time and date of the completed test.
13. Finally, save your changes, and you can choose to download, print, or share the completed form as required.

Complete your Backflow Test And Maintenance Form online today to ensure compliance and safety.