Get Pawtucket Water Supply & Newwa Backflow Prevention Device Assembly Test Report Form

The Pawtucket Water Supply & NEWWA Backflow Prevention Device Assembly Test Report Form is essential for documenting the testing of backflow prevention devices. This guide will provide user-friendly, step-by-step instructions to help you fill out the form accurately and efficiently online.

Follow the steps to fill out the form accurately online:

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the owner's name in the designated field to specify the property owner responsible for the backflow prevention device.
3. Fill in the date and time of the test in the appropriate spaces to document when the test was conducted.
4. Provide the mailing address of the property where the backflow prevention device is installed.
5. Enter your name as the tester along with your certification number, ensuring that your credentials are clearly mentioned.
6. Select the type of backflow prevention device from the options provided: RPZ, DCVA, PVB, or SRVB, by marking the corresponding checkbox.
7. Note the make and model number of the device being tested, ensuring accurate identification.
8. Indicate the exact device location and the corresponding size of the installation to provide precise details of the setup.
9. Check the box for the type of test being conducted, whether it is an annual test, a test after installation, or a test after repairs.
10. Record the test kit serial number and calibration date in the specified fields to guarantee the testing equipment's reliability.
11. Document the serial number of the device and check if any device was replaced by marking the appropriate option.
12. Evaluate each check valve's performance in Sections related to Check Valve No. 1 and No. 2, marking whether they are closed tight or leaking.
13. Assess the flow condition and record the differential pressure (DP) opening points as well as any relevant flow conditions evaluated.
14. Fill out the double check valve device assembly section and carry out a backpressure test, recording all relevant parameters.
15. Indicate the status of the downstream shut-off valve and the line pressure to reflect the overall test conditions.
16. Finally, select the protection type that corresponds to the installation, indicating whether it is a service line, fire service line, or internal domestic plumbing system.
17. In the remarks section, provide any additional observations or comments related to the test.
18. Ensure the tester’s signature is included at the end of the form to certify the results.
19. Once all information is complete, save any changes made, and opt to download, print, or share the filled-out document as necessary.

Complete the Pawtucket Water Supply & NEWWA Backflow Prevention Device Assembly Test Report Form online today.