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City of Golden CCC Program 1445 10th Street Golden CO 80401 pH: 3033848178 Fax: 3033848161Assembly Serial # Test Date/Time Gauge Serial # District Required Info Tester Certification # Date Certification
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How to fill out backflow prevention assembly test

01
Start by gathering all the necessary tools and equipment for the backflow prevention assembly test.
02
Make sure to wear appropriate protective gear, such as gloves and safety glasses.
03
Locate the backflow prevention assembly and identify the test cocks and shut-off valves.
04
Close all the shut-off valves leading to the assembly to isolate it from the water supply.
05
Open the test cocks on the assembly to release any pressure or water trapped inside.
06
Connect the backflow prevention assembly test kit to the test cocks using the appropriate adapters.
07
Follow the instructions provided with the test kit to perform the test.
08
Typically, the test involves applying a specific amount of pressure to each check valve and checking for any leaks.
09
Record the test results and compare them to the required standards and regulations.
10
If the assembly fails the test, make the necessary repairs or replacements.
11
Once the test is completed successfully, open the shut-off valves and restore the water supply to the assembly.
12
Clean and properly store the backflow prevention assembly test kit.
13
Document the test results and keep them for future reference or potential inspections.

Who needs backflow prevention assembly test?

01
Plumbers and contractors who install backflow prevention assemblies need to perform the test as part of their job.
02
Property owners and managers of buildings or facilities where backflow prevention assemblies are installed must ensure regular testing.
03
Municipalities and water utility companies often require periodic testing of backflow prevention assemblies for public safety.
04
Any individual or organization that wants to prevent the contamination of potable water sources may need a backflow prevention assembly test.
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A backflow prevention assembly test is a procedure that checks the functionality of a device designed to prevent the reverse flow of contaminated water into the public water supply. It ensures that the assembly is operating correctly to protect drinking water from potential contaminants.
Property owners or businesses that have backflow prevention assemblies installed are required to file a backflow prevention assembly test with the local water authority or governing body to ensure compliance with safety regulations.
To fill out a backflow prevention assembly test, you must provide details such as the type of assembly, the location, the date of the test, the name and license number of the tester, and the results of the test, indicating whether the assembly passed or failed.
The purpose of a backflow prevention assembly test is to ensure that backflow prevention devices are functioning properly to protect the potable water supply from contamination due to reverse flow.
The report must include the name and location of the property, type of backflow assembly, test results (pass/fail), date of the test, name and contact information of the tester, and any repairs or maintenance performed if applicable.
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