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OH Backflow Prevention Assembly Test Report - City of Columbus 2009 free printable template

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BACKFLOW PREVENTION ASSEMBLY TEST REPORT FAILED, ILLEGIBLE OR INCOMPLETE REPORTS WILL NOT BE ACCEPTED Please return to: MAIL: City of Columbus, Division of Water Backflow Compliance 918 Dublin Road
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How to fill out OH Backflow Prevention Assembly Test Report

01
Collect the necessary information about the backflow prevention assembly, including the make, model, and serial number.
02
Fill in the details of the company or individual performing the test.
03
Record the location of the backflow prevention assembly, including the address and specific placement if needed.
04
Indicate the type of assembly being tested.
05
Document the test results for each check performed on the assembly as per the required standards.
06
Sign and date the report, ensuring that it is completed by a certified tester.
07
Submit the completed report to the appropriate local authority or water department, as required.

Who needs OH Backflow Prevention Assembly Test Report?

01
Property owners with installed backflow prevention assemblies.
02
Plumbing contractors or companies performing the testing and maintenance.
03
Local government agencies or water authorities needing compliance documentation.
04
Insurance companies requiring proof of backflow prevention measures.
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The OH Backflow Prevention Assembly Test Report is a document that certifies the testing and maintenance of backflow prevention assemblies, ensuring that these devices operate correctly to prevent contamination of the potable water supply.
Businesses and property owners who have installed backflow prevention assemblies are required to file the OH Backflow Prevention Assembly Test Report, typically through a certified tester.
To fill out the OH Backflow Prevention Assembly Test Report, one must provide information including the location of the assembly, details of the tester, results from the testing process, and any corrective actions taken if the assembly failed the test.
The purpose of the OH Backflow Prevention Assembly Test Report is to document the condition and functioning of backflow prevention assemblies, ensuring compliance with health and safety regulations to protect water quality.
The report must include information such as the date of the test, the serial number and type of the assembly, the test results, the name and certification number of the tester, and any required follow-up actions.
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