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REDUCED PRESSURE BACKFLOW PREVENTER ANNUAL TEST REPORT Fill out form COMPLETELY and return to: City of Byron Public Works 680 Byron Main Court NE Byron, MN 55920 Phone: 5077753413 Email: tricke@byronmn.comNAME:

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How to fill out backflow test form

1. Start by gathering all necessary information such as the location of the backflow preventer, the type of backflow preventer, and the date of the test.
2. Fill out the top section of the form with your contact information and the date of the test.
3. Record the type and serial number of the backflow preventer in the designated section.
4. Check off the appropriate boxes to indicate if the backflow preventer passed or failed the test.
5. Record the test results, including the pressure readings and any repairs or adjustments that were made during the test.
6. Sign and date the form to certify that the test was completed properly.

Who needs backflow test form?

1. Plumbers
2. Building owners
3. Property managers
4. Municipalities
5. Water utility companies

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What is backflow test form?

Backflow test form is a document used to record the results of a backflow test, which checks the proper functioning of a backflow prevention device to protect drinking water from contamination.

Who is required to file backflow test form?

Property owners or facility managers who have backflow prevention devices installed on their premises are required to file the backflow test form.

How to fill out backflow test form?

To fill out the backflow test form, you must provide information about the backflow prevention device, the test results, and the qualified tester who conducted the test.

What is the purpose of backflow test form?

The purpose of the backflow test form is to ensure that backflow prevention devices are properly maintained and tested to protect the public water supply from contamination.

What information must be reported on backflow test form?

The backflow test form must include the type of backflow prevention device, the test results, the date of the test, the tester's qualifications, and any remedial actions taken if the device fails the test.