SC Backflow Device Test Report Form - Town of Swansea 2001-2025 free printable template
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BACKFLOW DEVICE TEST REPORT FORM Date Account Name/Business Name Account Address Account Number Meter Number Device Name Model Number Serial Number Size Device Location Tested by PRINT Check Test Before Repairs Mark Leaked Closed Tight No. 1 One Diff Press No. 2 Air-Inlet Valve or Relief Valve 1 Gate or Ball Circle One Opened at lbs. Differential Pressure Mark One Closed Tight and New Materials After Above data certified to be correct. Tester Signature Certification Number Company Name...
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How to fill out SC Backflow Device Test Report Form
01
Obtain the SC Backflow Device Test Report Form from your local water authority or their website.
02
Fill in the date of the test at the top of the form.
03
Provide information about the property owner including their name, address, and contact details.
04
Enter the location of the backflow prevention device being tested.
05
Fill out the type of backflow prevention device and its serial number.
06
Indicate the tester's name, certification number, and contact information.
07
Conduct the backflow test according to manufacturer guidelines and local regulations.
08
Record the test results in the designated sections of the form, including pass/fail status.
09
Sign and date the form to certify the results.
10
Submit the completed form to the appropriate water authority as required.
Who needs SC Backflow Device Test Report Form?
01
Property owners with installed backflow prevention devices.
02
Commercial businesses that use public water supply where backflow devices are required by law.
03
Water service providers and municipalities that need to monitor compliance with backflow prevention regulations.
04
Plumbing contractors and testers who are responsible for conducting tests and maintaining records.
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What is SC Backflow Device Test Report Form?
The SC Backflow Device Test Report Form is a document used to report the results of testing backflow prevention devices to ensure they are functioning correctly and protecting the public water supply.
Who is required to file SC Backflow Device Test Report Form?
Licensed professionals who test backflow prevention devices are required to file the SC Backflow Device Test Report Form on behalf of property owners.
How to fill out SC Backflow Device Test Report Form?
To fill out the SC Backflow Device Test Report Form, testers need to include information such as the date of the test, the location of the device, the type of device, test results, and the tester's certification details.
What is the purpose of SC Backflow Device Test Report Form?
The purpose of the SC Backflow Device Test Report Form is to ensure compliance with state regulations, to document that backflow devices are tested regularly, and to maintain a safe drinking water supply.
What information must be reported on SC Backflow Device Test Report Form?
The SC Backflow Device Test Report Form must report the tester's name and certification number, the property owner's name, device type, installation date, test results, and any repairs made if the device fails.
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