Get the free Backflow Prevention Checklist - City of Bothell

Backflow Prevention 51 Buildings and/or structures serviced by the City of Bothell Water Department, which are deemed nonconforming to the cross connection requirements, will need to obtain a separate

How to fill out backflow prevention checklist

How to fill out backflow prevention checklist:

1. Begin by gathering all the necessary information and documents related to the backflow prevention system. This may include previous inspection reports, maintenance records, and relevant permits.
2. Review the checklist thoroughly to understand the different sections and requirements. Familiarize yourself with the terminology and specifications mentioned in the checklist.
3. Start filling out the checklist systematically, ensuring that you address each item accurately. Provide all the necessary details, such as the location of the backflow prevention assembly, the date of installation, and the manufacturer's name.
4. Pay close attention to the inspection and testing sections of the checklist. These typically involve checking the condition of the assembly, testing its functionality, and verifying the proper functioning of related components.
5. Use the appropriate codes or standards mentioned in the checklist to assess the compliance of the backflow prevention system. This may include evaluating pressure levels, verifying the presence of approved backflow prevention devices, or ensuring the correct installation of air gaps.
6. Document any repairs or maintenance performed on the system since the last inspection. Include dates, descriptions of the work done, and any supporting documents, such as invoices or work orders.
7. Complete all the required fields of the checklist, ensuring that the information provided is accurate and up to date. Avoid leaving any sections unanswered or incomplete, as this may lead to additional follow-up or non-compliance issues.

Who needs backflow prevention checklist:

1. Plumbers and plumbing contractors who install or maintain backflow prevention systems should frequently utilize the backflow prevention checklist to ensure compliance with regulations and industry standards.
2. Municipalities and local government authorities responsible for overseeing water supply networks often require property owners and businesses to perform regular inspections and submit completed checklists to safeguard the public water supply from contamination.
3. Facilities that handle potentially hazardous substances, such as industrial plants, hospitals, laboratories, or commercial kitchens, should use the backflow prevention checklist to implement proper backflow prevention measures and protect the integrity of their internal water supply systems.

For pdfFiller’s FAQs

What is backflow prevention checklist?

Backflow prevention checklist is a document used to ensure that backflow preventers are properly installed and maintained to protect potable water sources from contamination.

Who is required to file backflow prevention checklist?

All property owners with backflow preventers installed on their premises are required to file the backflow prevention checklist.

How to fill out backflow prevention checklist?

The backflow prevention checklist should be filled out by inspecting the backflow preventers and recording information such as the device type, location, test results, and maintenance records.

What is the purpose of backflow prevention checklist?

The purpose of the backflow prevention checklist is to ensure that backflow preventers are functioning properly and meeting regulatory requirements to prevent the contamination of drinking water.

What information must be reported on backflow prevention checklist?

Information such as backflow preventer type, location, test results, maintenance records, and any repairs or replacements should be reported on the backflow prevention checklist.

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