Get Backflow Prevention Assembly Test And Maintenance Report *

Filling out the Backflow Prevention Assembly Test and Maintenance Report online is essential for ensuring compliance with local regulations. This guide will walk you through each section of the form, providing clear and detailed instructions for accurate completion.

Follow the steps to successfully complete your report.

1. Click ‘Get Form’ button to acquire the document and open it in your preferred editor.
2. Begin by filling out the property information. Enter the name of the property in the designated space, followed by the property's address, city, state, ZIP code, and contact phone number.
3. Provide the mailing address and the name of the contact person responsible for this report. This ensures the right individual is associated with the maintenance of the backflow prevention assembly.
4. Select the type of assembly from the options provided. Indicate whether the assembly is new, existing, or replaced by checking the appropriate box and, if applicable, include the old serial number.
5. Fill in the details of the assembly by stating the manufacturer, model number, size, and serial number. Also, specify the location of the assembly and the installation date.
6. Answer whether the assembly has been installed in accordance with manufacturer recommendations and/or the city’s International Plumbing Code.
7. Proceed to the testing section for the Reduced Pressure Principle Assembly and the Double Check Valve Assembly. Record the initial test results for the check valves and the relief valve, indicating whether they were closed tight, leaked, or held pressure.
8. Document any repairs made and materials used during the maintenance process.
9. Provide details about the test gauge used, including make, model, serial number, and calibration date. This confirms that the gauge was tested annually and meets the necessary standards.
10. Include any remarks related to the testing process, ensuring you communicate important notes that may affect the report's validity.
11. Indicate the backflow test status by selecting either pass or fail.
12. Finally, enter the firm name, firm address, and firm phone number. Include the tester's name, certification number, and the date of testing.
13. Once all fields are completed, review the report for accuracy. You can then save changes, download, print, or share the form as necessary.

Complete your Backflow Prevention Assembly Test and Maintenance Report online today for compliance and peace of mind.