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This document is a test report for backflow prevention assemblies used in various applications. It gathers information about the assembly's location, type, test results, and certifies the accuracy

How to fill out backflow prevention assembly test

How to fill out Backflow Prevention Assembly Test Report

1. Begin by entering the date of the test at the top of the report.
2. Write the name and address of the property where the backflow prevention assembly is installed.
3. Provide the type, make, model, and serial number of the backflow prevention assembly.
4. Indicate the installation date of the assembly.
5. Fill in the test results for each assembly component, including air gaps and check valves.
6. Specify the name and certification number of the person conducting the test.
7. Sign and date the report to confirm the testing is complete.
8. Submit the report to the appropriate local authority or water purveyor.

Who needs Backflow Prevention Assembly Test Report?

1. Water utility companies to ensure compliance with safety regulations.
2. Property owners to maintain safe water supply systems.
3. Plumbers and contractors who install and test backflow prevention systems.
4. Regulatory agencies that enforce public health standards.

People Also Ask about

Shall backflow prevention assemblies be tested?

6 Testing and Maintenance of Backflow Prevention Assemblies. Assemblies that are designed to be field tested shall be tested prior to final inspection of the initial installation and once each year thereafter.

How do you test backflow preventers?

First, the number 2 shut off valve on the backflow is turned off. A test kit is placed on the device. The test kit uses the water left in the backflow. Once the test is complete, the kit is removed, and the water is turned back on slowly, which prevents pressure surges from occurring.

What is a backflow test report?

Backflow testing is a plumbing service that checks your backflow preventer device by assessing its pressure levels. When backflow is present, untreated or contaminated water can be back-siphoned into your clean water. For this reason, testing guarantees the water you use for drinking and showering is safe and sterile.

What is a backflow assembly test?

A backflow assembly usually has a check valve, which maintains the pressure needed to hold back wastewater. To pass an inspection, the valve must hold a minimum pressure. The inspector will also test the relief valves to ensure they open before the system reaches a certain pressure differential.

For pdfFiller’s FAQs

What is Backflow Prevention Assembly Test Report?

A Backflow Prevention Assembly Test Report is a document that verifies the proper functioning of backflow prevention devices, which are installed to protect the public water supply from contamination.

Who is required to file Backflow Prevention Assembly Test Report?

Property owners, facility managers, and plumbing contractors who have installed backflow prevention devices are typically required to file the Backflow Prevention Assembly Test Report with the local water authority.

How to fill out Backflow Prevention Assembly Test Report?

To fill out a Backflow Prevention Assembly Test Report, one must provide details such as the location of the assembly, the type of assembly, test results, the tester's name and certification number, and the date of testing.

What is the purpose of Backflow Prevention Assembly Test Report?

The purpose of the Backflow Prevention Assembly Test Report is to ensure that backflow prevention devices are functioning properly to prevent the reverse flow of contaminated water into the clean water supply.

What information must be reported on Backflow Prevention Assembly Test Report?

The Backflow Prevention Assembly Test Report must include information such as the test location, identification of the backflow device, test results, repairs made if any, details of the certified tester, and the date of the test.