Get Oh Backflow Prevention Assembly Test Report - City Of Columbus 2015-2025

Filling out the OH Backflow Prevention Assembly Test Report is essential for approved testers to submit accurate test report information to the City of Columbus. This guide will walk you through each section of the form to ensure you can complete it efficiently and correctly.

Follow the steps to complete the form online

1. Press the ‘Get Form’ button to acquire the document and open it in your editing interface.
2. Begin by entering the customer and property information. Fill out the property address, ensuring to include the zip code, the customer's or business name, hazard number, contact person's name, and their phone and fax numbers.
3. Next, complete the device information section. Indicate whether the device is existing or a replacement by checking the appropriate box. Then, provide the old assembly serial number, type of assembly, make, model, size, and serial number.
4. Describe the hazard being isolated, such as a boiler or irrigation system, and provide the location of the assembly.
5. For the double check assembly, fill out the test results for each valve (initial test, 1st check valve, 2nd check valve) and mark whether each passed or failed. Record the pressure readings noted in psid.
6. Continue to the reduced pressure assembly section and provide test results for the relief valve opening point and the outlet valve. Indicate the pressure units used and whether they passed or failed.
7. Complete the repairs and materials used section, detailing any repairs made post-testing, including re-test results for applicable valves.
8. Answer whether the assembly meets proper piping installation requirements by checking 'YES' or 'NO'.
9. Complete the air gap inspection section. Indicate whether the required air gap separation was provided.
10. Present a summary at the end by checking whether the assembly passed or failed. Make any additional comments if necessary.
11. Finally, enter the certified tester information section. Print the tester's name, certification number, test equipment details, tester's company name, phone number, and include the tester's signature and date.

Complete your OH Backflow Prevention Assembly Test Report online today.