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BACKFLOW PREVENTION ASSEMBLY TEST REPORT Name of Premise: Street Address: Location of Assembly:Assembly: Manufacturer (make) Existing New ModelReplacement Type of Assembly: PBA PBA PDA DCD AAG psi. PRESSURE

How to fill out annual backflow prevention assembly

How to fill out annual backflow prevention assembly

1. Gather all necessary information and documentation
2. Inspect the backflow prevention assembly for any damages or leaks
3. Shut off the water supply to the assembly
4. Remove any debris or sediment from the assembly
5. Disassemble the assembly and clean each component thoroughly
6. Replace any faulty or worn-out parts
7. Reassemble the assembly
8. Perform a pressure test to ensure proper functioning
9. Fill out the annual backflow prevention assembly form with all relevant details
10. Submit the form to the local authorities or relevant department

Who needs annual backflow prevention assembly?

1. Commercial buildings
2. Industrial facilities
3. Municipalities
4. Hospitals
5. Schools and universities
6. Government facilities
7. Restaurants and food service establishments
8. Chemical and pharmaceutical plants
9. Waste treatment facilities

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What is annual backflow prevention assembly?

An annual backflow prevention assembly is a device installed in a plumbing system designed to prevent contaminated water from flowing back into the clean water supply. It is typically required to be tested and reported on an annual basis.

Who is required to file annual backflow prevention assembly?

Property owners, businesses, and facilities that have a backflow prevention assembly installed in their water system are required to file an annual backflow prevention assembly report.

How to fill out annual backflow prevention assembly?

To fill out an annual backflow prevention assembly report, obtain the necessary form from your local water authority, complete the required fields such as the assembly details, test results, and service technician information, and then submit it as per your jurisdiction’s guidance.

What is the purpose of annual backflow prevention assembly?

The purpose of an annual backflow prevention assembly is to ensure that the backflow prevention devices are functioning properly to safeguard the public water supply from potential contamination.

What information must be reported on annual backflow prevention assembly?

The information that must be reported typically includes the type of backflow prevention assembly, its location, the results of the annual testing, the date of the test, and the name and certification number of the tester.