Get the free Backflow Verification Form - City of Raleigh - raleighnc

Public Utilities Cross Connection Program Containment Backflow Allowance Verification Form Company Name: Service Address: Meter #: Location: Pin: Information on containment backflow assembly for the

How to fill out backflow verification form

How to fill out a backflow verification form:

1. Start by gathering all necessary information: Before filling out the form, ensure you have all the required details such as the property address, contact information, and any specific instructions provided by the entity requesting the verification.
2. Identify the type of backflow preventer: The form may ask you to specify the type of backflow preventer installed on the property. Common types include double-check valves, reduced pressure zone (RPZ) valves, and pressure vacuum breakers (PVB).
3. Provide accurate backflow preventer details: Fill in the form with the specific details of the backflow preventer, such as the make, model, and serial number. This information can typically be found on the physical device or in any maintenance records.
4. Document the installation date and last maintenance check: The form may require you to note the date when the backflow preventer was installed and the most recent date it was inspected or maintained. Include any relevant documentation or licenses of the technician who performed the maintenance.
5. Verify compliance with local regulations: Some areas have specific regulations or codes regarding backflow prevention. Ensure you answer any questions on the form confirming that the backflow preventer is in compliance with local guidelines.
6. Sign and date the form: Once you have completed all the necessary sections, sign and date the form to confirm its accuracy. Make sure to keep a copy of the completed form for your records.

Who needs a backflow verification form:

1. Property owners or managers: Backflow verification forms are typically required for residential, commercial, or industrial properties where a backflow preventer is installed. Property owners or managers are responsible for ensuring compliance with backflow prevention regulations.
2. Water utility companies: Water utility companies often require property owners to submit backflow verification forms as part of their ongoing efforts to protect the public water supply from contamination.
3. Local regulatory agencies: Municipalities or local government agencies might request backflow verification forms to ensure compliance with backflow prevention regulations and to maintain the overall safety of the water distribution system.

Remember, it is best to consult the specific requirements of your locality or the entity requesting the backflow verification form to ensure accurate and complete submission.

For pdfFiller’s FAQs

What is backflow verification form?

The backflow verification form is a document that certifies that backflow prevention devices are functioning properly to prevent the contamination of potable water.

Who is required to file backflow verification form?

Property owners or water system managers are typically required to file the backflow verification form.

How to fill out backflow verification form?

The backflow verification form must be completed by a certified backflow prevention device tester and submitted with the necessary documentation.

What is the purpose of backflow verification form?

The purpose of the backflow verification form is to ensure that backflow prevention devices are in proper working order to protect public health and safety.

What information must be reported on backflow verification form?

The backflow verification form typically requires information about the certified tester, the date of testing, the location of the backflow prevention device, and the results of the test.

How can I send backflow verification form to be eSigned by others?

When your backflow verification form is finished, send it to recipients securely and gather eSignatures with pdfFiller. You may email, text, fax, mail, or notarize a PDF straight from your account. Create an account today to test it.

Where do I find backflow verification form?

The pdfFiller premium subscription gives you access to a large library of fillable forms (over 25 million fillable templates) that you can download, fill out, print, and sign. In the library, you'll have no problem discovering state-specific backflow verification form and other forms. Find the template you want and tweak it with powerful editing tools.

How do I edit backflow verification form on an Android device?

You can make any changes to PDF files, such as backflow verification form, with the help of the pdfFiller mobile app for Android. Edit, sign, and send documents right from your mobile device. Install the app and streamline your document management wherever you are.