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BACKFLOW PREVENTION ASSEMBLY TEST & MAINTENANCE REPORT Customer Name: Mailing Address: City State Zip: SERVICE LOCATION: ASSEMBLY LOCATION: MFR: MODEL: SERIAL # TYPE: LINE PRESSURE: INITIAL TEST REPAIRS

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What is backflow prevention assembly test?

Backflow prevention assembly test is a procedure to ensure that water is flowing in the correct direction to prevent contamination of the water supply.

Who is required to file backflow prevention assembly test?

Certain businesses and facilities that have backflow prevention assemblies installed are required to file backflow prevention assembly test.

How to fill out backflow prevention assembly test?

You can fill out backflow prevention assembly test by conducting the test, documenting the results, and submitting the report to the relevant authority.

What is the purpose of backflow prevention assembly test?

The purpose of backflow prevention assembly test is to protect the public water supply from potential contamination.

What information must be reported on backflow prevention assembly test?

The report must include test results, date of test, name of tester, and any necessary maintenance or repairs.

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