Get the free BACKFLOW ASSEMBLY TEST REPORT - City of Grass Valley

BACKFLOW ASSEMBLY TEST REPORT City of Grass Valley Public Works Department Water Distribution Division 125 E Main Street, Grass Valley, CA 95945 Phone: (530) 477-4625 Fax: (530) 272-1807 BUSINESS

How to fill out backflow assembly test report

How to fill out backflow assembly test report:

1. Begin by gathering all the necessary information regarding the backflow assembly test. This includes the test date, location, the type of backflow assembly being tested, and any other relevant details.
2. Clearly indicate the name of the person or company conducting the test. Include their contact information for future reference.
3. In the report, provide a detailed description of the backflow assembly being tested. This includes its make, model, size, and any other pertinent specifications.
4. Document the test procedure step by step. This typically involves conducting various tests, such as flow tests, differential pressure tests, and a check for leaks. Provide accurate measurements and observations during each test.
5. If any issues or failures are encountered during the test, make sure to clearly document them in the report. Include a thorough description of the problem and any action taken to resolve it.
6. Note any repairs or maintenance carried out on the backflow assembly during the test. Include specific details like the replacement of parts or adjustments made.
7. Provide a summary of the backflow assembly's overall performance during the test. This includes whether it passed or failed, and any recommendations for further actions.
8. Sign and date the report at the end to certify its accuracy and completion.

Who needs backflow assembly test report:

1. Plumbing and mechanical contractors who have installed backflow prevention devices or assemblies are typically required to submit a backflow assembly test report. This is necessary to ensure the proper functioning of these devices and maintain the safety of the water supply.
2. Municipal water authorities often require property owners to submit a backflow assembly test report to verify that their backflow prevention devices are in compliance with regulations. This helps prevent the contamination of public water supplies.
3. Industrial facilities and commercial buildings that use water for various purposes, such as manufacturing processes or irrigation, may also need to submit a backflow assembly test report. This ensures the integrity of their internal water systems and prevents potential cross-connections.
4. Homeowners who have backflow prevention devices installed, either as a requirement or for their own peace of mind, may choose to conduct regular tests and maintain a record of these tests with a backflow assembly test report. This can be useful for future reference and as proof of compliance if needed.

For pdfFiller’s FAQs

What is backflow assembly test report?

A backflow assembly test report is a document that records the results of a test conducted on a backflow prevention assembly to ensure its proper functioning and to prevent the contamination of potable water supply.

Who is required to file backflow assembly test report?

The individuals or businesses responsible for the installation, maintenance, or repair of backflow prevention assemblies are typically required to file the backflow assembly test report.

How to fill out backflow assembly test report?

To fill out a backflow assembly test report, you need to record details such as the location of the assembly, the test date, the name of the tester, the test results, and any necessary repairs or maintenance carried out.

What is the purpose of backflow assembly test report?

The purpose of a backflow assembly test report is to ensure that backflow prevention assemblies are functioning correctly, thereby preventing the contamination of potable water supply and safeguarding public health.

What information must be reported on backflow assembly test report?

A backflow assembly test report typically requires information such as the assembly's location, date of the test, test results, tester's name, and any repairs or maintenance performed.

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