Get Pa American Water Backflow Prevention Device Test Form 2016-2025
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How to fill out the PA American Water Backflow Prevention Device Test Form online
Completing the PA American Water Backflow Prevention Device Test Form online is a straightforward process that ensures your backflow prevention device is tested and certified by a qualified professional. This guide will walk you through each section of the form, providing clear instructions to help you successfully submit your application.
Follow the steps to fill out the form accurately and efficiently.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering the location information. Fill in the account number and premise number as required. Specify the service type by selecting either Domestic, Fire, or Irrigation, and provide the service address details.
- In the device information section, input the type of assembly and its serial number. Indicate the size of the backflow device and provide the manufacturer/model number along with the water meter number.
- Proceed to the 'To Be Completed By Tester' section. Record the results of the initial test by noting the date and time. Fill out the performance details of check valves and pressure differential relief valve, indicating whether they held pressure, leaked, or did not open.
- Repeat the process for the final test results, entering the date, time, and the performance details as you did for the initial test.
- In the air gap section, measure and note the vertical inches above the overflow rim, along with the supply size diameter.
- Complete the comments section if necessary. Then, fill in the tester information for both the initial and final tests, marking whether each test passed or failed, and providing the tester's name, company, phone number, calibration date, equipment serial number, and certification testing number.
- Finally, ensure the tester signs and dates the report after confirming the information is true. Review all sections for accuracy, then save changes, download, print, or share the completed form as required.
Complete your PA American Water Backflow Prevention Device Test Form online today for efficient processing.
Under the 1974 Pennsylvania Safe Drinking Water Act, the Pennsylvania Department of Environmental Resources requires that customers eliminate cross-connections or backflow prevention devices. This regulation applies to individual homes, businesses, and commercial and industrial establishments.
Fill PA American Water Backflow Prevention Device Test Form
Testing Equipment Calibration Date: FINAL. If the device does not pass, you must repair or replace the device and then have the device re-tested. A qualified Backflow Device Tester must perform the test. How often do I have to have my backflow device tested? Backflow devices are required to be tested upon installation and at annual intervals thereafter. American Backflow Prevention Assembly Tester Certification Examination and Cross-Connection Control Specialist Examination. In order to prevent potential backflow, some customers are required to install and maintain backflow prevention devices on the main water service lines. The device is to be tested every twelve months at a minimum. An ASSE Certified Tester must submit the results through our Backflow Test Submission Portal.
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