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BACKFLOW PREVENTION ASSEMBLY TEST REPORT Failed, Illegible or Incomplete Reports Will Not Be Accepted Customer and Property InformationPlease Print Please return to: MAIL: Village of Granville Water
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How to fill out a Backflow Prevention Report:

01
Start by gathering all the necessary information about the backflow prevention device, including its make, model, and serial number.
02
Note the location of the device and any relevant details about its installation, such as the date it was installed and who installed it.
03
Inspect the device for any signs of damage, leaks, or malfunction. Document any issues you encounter during the inspection.
04
Check the device's functioning by conducting a test. Follow the manufacturer's instructions or consult a certified professional to perform the test accurately.
05
Record the test results, including the pressure readings and any other relevant data. Ensure that the test meets the required standards and regulations.
06
If any repairs or maintenance are needed, note them down and schedule them accordingly. Make sure to include the details of the repairs or maintenance performed in the report.
07
In the report, provide a clear and concise description of the backflow prevention device, its location, and any observations made during the inspection.
08
Sign and date the report, indicating that you have completed the inspection and performed the necessary tests.
09
Submit the report to the appropriate authorities or stakeholders responsible for maintaining and managing backflow prevention devices.

Who needs a Backflow Prevention Report:

01
Property owners and managers: It is their responsibility to ensure that backflow prevention devices are installed and functioning properly. They need the report to comply with local regulations and demonstrate the safe operation of the devices.
02
Local authorities and regulatory bodies: They require the report to verify that backflow prevention devices are being adequately maintained and that the water supply is protected from any potential contamination risks.
03
Contractors and plumbers: They may need the report to document their work and ensure compliance with relevant standards. It can also serve as documentation for future maintenance or repairs.
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Backflow prevention report is a document that outlines the measures taken to prevent the reverse flow of contaminated water into a clean water supply.
Property owners or managers of buildings with backflow prevention devices are required to file the backflow prevention report.
The backflow prevention report should be filled out with details of the backflow prevention devices installed, maintenance schedules, and any incidents of backflow.
The purpose of the backflow prevention report is to ensure that the backflow prevention devices are properly maintained and functioning to protect the quality of the water supply.
The backflow prevention report must include details of the backflow prevention devices, testing and maintenance records, and any incidents of backflow.
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