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INSTRUCTIONS FOR COMPLETING DOH1013 (9/91) REPORT ON TEST AND MAINTENANCE OF BACKFLOW PREVENTION DEVICE PART A To Be Completed by Certified Tester #Indicate the test year and whether initial or annual
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How to fill out backflow prevention device application

01
Obtain a backflow prevention device application form from your local water utility or regulatory agency.
02
Provide all requested information on the form, including your contact information, property details, and proposed backflow prevention device location.
03
Attach any required supporting documents, such as a site map or engineering drawings.
04
Submit the completed application form and any supporting documents to the appropriate agency for review and approval.
05
Follow up with the agency to address any feedback or additional requirements for the application.

Who needs backflow prevention device application?

01
Any property owner or manager who is required by their local water utility or regulatory agency to install a backflow prevention device on their property.
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Backflow prevention device application is a form used to request installation of devices to protect drinking water from contamination caused by backflow.
Property owners and businesses connected to public water systems are typically required to file backflow prevention device applications.
Backflow prevention device applications can typically be filled out online or submitted in person to the appropriate water department or authority.
The purpose of the backflow prevention device application is to ensure that proper safeguards are in place to protect public drinking water from contamination.
Information such as property address, contact information, type of backflow prevention device needed, and a site plan may be required on the application.
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