Get Maintenance Report Form

Filling out the Maintenance Report Form accurately is crucial for the integrity of backflow prevention measures. This guide provides step-by-step instructions to help you complete the form online efficiently and correctly.

Follow the steps to fill out the Maintenance Report Form online

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your name in the designated field. Ensure that you type your name clearly and accurately.
3. Next, fill in your account number. This helps identify your service record.
4. Provide your complete address including street name, city, state, and zip code.
5. In the contact section, enter your telephone number, ensuring that it is current and valid.
6. Specify the device type you are testing. Select from the options provided, such as Reduced Pressure Principle Backflow Prevention Assembly or Double Check Valve Backflow Prevention Assembly.
7. Input the serial number of the device, which is typically found on the unit itself.
8. Fill out the manufacturer and model number, ensuring that these details match the specifications of the equipment.
9. Enter the service number associated with the device, if applicable. This may be a unique identifier linked with your service.
10. Indicate the test due date by selecting the appropriate date on the calendar feature in the form.
11. Complete the municipality field with the name of your local authority or municipality.
12. For static line pressure, provide the measurement in PSID.
13. Fill in details for both check valves, marking if they leaked or closed tight during testing. Record any pressures observed.
14. Document any maintenance performed on the device, noting if it was cleaned or repaired. Describe the repairs and materials used.
15. Include the date for each maintenance action taken.
16. If the device was newly installed, ensure to mention this and that it must be tested online.
17. Complete the final test of the device, noting the results for each test valve.
18. Sign the certification section, confirming the validity of the data entered. Include your printed name, certification number, and the date of the test.
19. Lastly, save your changes to the form. You may then download, print, or share the finalized document as needed.

Start filling out the Maintenance Report Form online today to ensure your compliance and safety.