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MN Backflow Preventer Installation/Test Report - City of St. Louis Park 2022-2025 free printable template

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Backflow preventer installation/test report All information must be typed or clearly printed in black ink. Site address: ___ Current owner/occupant: ___ Contact full name: ___ Phone number: ___ Mailing
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How to fill out MN Backflow Preventer InstallationTest Report

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How to fill out MN Backflow Preventer Installation/Test Report - City

01
Start by downloading the MN Backflow Preventer Installation/Test Report form from the City’s official website.
02
Fill in the identification details at the top of the form, including the installation address and contact information.
03
Indicate the type of backflow preventer being installed or tested, along with its model and serial number.
04
Provide details about the installation location, including any relevant schematics or diagrams if necessary.
05
Record the date of installation or testing.
06
Document the results of the test, including the pressure readings and any issues encountered.
07
If modifications were made during installation, describe these changes clearly.
08
Sign and date the report at the bottom to certify that the information provided is accurate.
09
Submit the completed report to the appropriate city department, either electronically or by mail, as per the city guidelines.

Who needs MN Backflow Preventer Installation/Test Report - City?

01
Property owners who have a backflow preventer installed.
02
Plumbers or contractors performing installations or testing of backflow preventers.
03
Municipal water authorities or city departments responsible for monitoring water safety.
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The MN Backflow Preventer Installation/Test Report - City is a document that records the installation and testing of backflow prevention devices to ensure that they are functioning correctly to protect the public water supply from contamination.
Water system owners, plumbers, or contractors who install or test backflow prevention devices are required to file the MN Backflow Preventer Installation/Test Report - City.
To fill out the MN Backflow Preventer Installation/Test Report - City, provide the necessary details including the address of the installation site, the type of backflow device, the test results, date of installation/test, and the name and contact information of the person conducting the test.
The purpose of the MN Backflow Preventer Installation/Test Report - City is to document the installation and testing of backflow prevention devices to ensure they meet safety standards and to maintain the integrity of the public water supply.
The information that must be reported includes the installation location, type of backflow preventer, test results, date of installation/test, the name and license number of the tester, and any additional notes relevant to the installation or testing process.
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