FL Backflow Preventer Field Test Report - Orange County 2017-2026 free printable template

Orange County Utilities Water Division BACKFLOW PREVENTER FIELD TEST REPORT PLEASE PRINT or TYPECustomer Name: ___ Service Address: ___ City: ___ State: ___ Zip: ___ Account #: ___ Meter #:___ Reading:

How to fill out FL Backflow Preventer Field Test Report

How to fill out FL Backflow Preventer Field Test Report

1. Begin by obtaining the FL Backflow Preventer Field Test Report form from the appropriate regulatory body.
2. Fill in the date of the test at the top of the report.
3. Enter the location of the backflow preventer, including the address and any relevant identifying information.
4. Provide details about the backflow preventer device, including manufacturer, model number, and serial number.
5. Record the names and license numbers of the individuals conducting the test.
6. Document the initial pressure readings of the backflow preventer according to the provided sections on the report.
7. Conduct the necessary field tests as per the guidelines for the specific backflow preventer type and record the results.
8. If any repairs or maintenance were performed, document those actions on the report.
9. Sign and date the report upon completion of the tests.
10. Submit the completed report to the appropriate authority as required.

Who needs FL Backflow Preventer Field Test Report?

1. Property owners with backflow prevention devices.
2. Plumbers or contractors performing backflow testing.
3. Local water utility companies.
4. Building inspectors or regulatory agencies overseeing public health.

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What is FL Backflow Preventer Field Test Report?

The FL Backflow Preventer Field Test Report is a document that verifies the operational status and performance of backflow prevention assemblies installed in Florida. It is used to ensure compliance with state regulations that prevent contaminated water from flowing back into clean water systems.

Who is required to file FL Backflow Preventer Field Test Report?

Certified backflow testers are required to file the FL Backflow Preventer Field Test Report. Property owners with backflow prevention devices are also responsible for ensuring that the report is submitted to their local water authority within the required time frame.

How to fill out FL Backflow Preventer Field Test Report?

To fill out the FL Backflow Preventer Field Test Report, a certified backflow tester must: 1) provide the test date, 2) list the property owner's name and address, 3) specify the type and location of the backflow device, 4) document the test results for each check valve, including any repairs made, and 5) include the tester's certification information.

What is the purpose of FL Backflow Preventer Field Test Report?

The purpose of the FL Backflow Preventer Field Test Report is to ensure the proper functioning of backflow prevention devices and to protect public health by preventing the contamination of drinking water supplies. The report serves as an official record of the test results and maintenance of these devices.

What information must be reported on FL Backflow Preventer Field Test Report?

The FL Backflow Preventer Field Test Report must include the following information: property address, owner's name, type of backflow preventer, serial number, test results for each check valve, any repairs or maintenance performed, and the signature and certification number of the tester.