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BACKFLOW PREVENTION ASSEMBLY TEST REPORT Town of Upper Department of Public Works Cross Connection Unit 400 S. Main St. Upper, VA 22701 (540) 8258671TEST DATE: TAG # Please note that this form must
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To fill out a cross connection unit, follow these steps:
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First, identify the input and output ports on the cross connection unit.
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Connect the outgoing cables to the output ports of the cross connection unit.
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Double-check the wiring to ensure that no cables are crossed or connected incorrectly.
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Document the connections made in a clear and organized manner for future reference.
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Regularly inspect and maintain the cross connection unit to ensure proper functioning.

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Cross connection unit is a device that prevents backflow of contaminants into the drinking water supply.
Property owners or managers are typically required to file a cross connection unit.
You can fill out a cross connection unit by providing information about the location of the device, its purpose, and any maintenance records.
The purpose of a cross connection unit is to protect the safe drinking water supply from contamination.
Information such as the location of the device, type of backflow preventer, installation date, and maintenance records must be reported on a cross connection unit.
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