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BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT The following form must be completed for each assembly tested. A signed and dated original must be submitted to the public water supplier for

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How to fill out backflow prevention assembly test

01

Shut off the water supply to the backflow prevention assembly.

02

Remove the test port fittings from the assembly.

03

Insert the test kit hoses into the test ports.

04

Open the test cocks on the assembly to allow water to flow through the test kit.

05

Record the pressure readings on the test kit gauges.

06

Compare the readings to the acceptable range for the specific type of backflow prevention assembly.

07

If the readings fall within the range, the assembly has passed the test. If not, it may need to be repaired or replaced.

08

Reassemble the assembly and turn the water supply back on.

Who needs backflow prevention assembly test?

01

Property owners with commercial or industrial facilities

02

Municipalities and water utilities

03

Plumbing contractors

04

Irrigation companies

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What is backflow prevention assembly test?

Backflow prevention assembly test is a procedure to verify the proper functioning of a backflow prevention device.

Who is required to file backflow prevention assembly test?

Property owners, businesses, and municipalities are typically required to file backflow prevention assembly test.

How to fill out backflow prevention assembly test?

Backflow prevention assembly tests are typically filled out by certified professionals who perform the test.

What is the purpose of backflow prevention assembly test?

The purpose of backflow prevention assembly test is to ensure that drinking water is protected from contamination.

What information must be reported on backflow prevention assembly test?

Information such as the type of backflow prevention device, test results, and contact information of the individual performing the test must be reported.

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