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Get Nj Bwse-citr-iq 2013-2026

Quarter 01/01-03/31 04/01-06/30 07/01-09/30 10/01-12/31 Date of test / / To: Instructions: This form is to be completed for each test of each approved valve. It is to be mailed to the Supplier of Water and Local Administrative Authority within 5 days of each test and inspection performed by a Certified Tester. These forms shall be kept at the facility for a period of 5 years (N.J.A.C. 7:10-10.2(f)) and be exhibited upon request. From: (Name of Permit Holder) The backflow prevention d.

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How to fill out the NJ BWSE-CITR-IQ online

The NJ BWSE-CITR-IQ form is essential for reporting the quarterly tests of backflow prevention devices in New Jersey. This guide provides a comprehensive overview of how to accurately complete this form online, ensuring compliance with state regulations.

Follow the steps to accurately fill out the NJ BWSE-CITR-IQ form.

  1. Click ‘Get Form’ button to obtain the NJ BWSE-CITR-IQ form and open it in the document management system.
  2. Fill in the 'Date of Test' section by entering the date when the test was conducted, formatted as MM/DD/YYYY.
  3. In the 'From' section, provide the name of the permit holder responsible for the backflow prevention device. Ensure accuracy to avoid any discrepancies.
  4. In the 'Description of Valve' section, document the manufacturer, model number, size, and serial number of the valve being tested.
  5. Complete the testing results by filling in the appropriate checkboxes for the results of the 'Pressure Test' and 'Internal Inspection' as required.
  6. List any repairs made and materials used in the designated area, and note the results of the test after any repairs.
  7. In the 'Certified Testers Name' section, provide the name of the certified tester, their signature, and the certifying authority including their ID and expiration date.
  8. Complete the 'Witnesses to Test and Inspection' area by entering the titles of individuals present during the testing process.
  9. Review all information filled out to ensure accuracy and clarity before submission.
  10. Once all fields are completed, save changes to your document, and choose to download or print the form for final submission.

Complete your NJ BWSE-CITR-IQ form online today for timely compliance and reporting.

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Every water line on a property must have a backflow prevention device that is regularly maintained and annually tested.

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