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APPENDIX DCompliance Division 224 Grand River Avenue Brantford, Ontario, N3T 4Y8 Phone: 5197594150 ext. 5227 Email: backflow@brantford.caBackflow Prevention Device Inspection and Testing Report To
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How to fill out backflow preventer test and

01
To fill out a backflow preventer test, follow these steps:
02
Gather all necessary equipment and paperwork, including the backflow preventer test report form and a test kit.
03
Locate the backflow preventer device and ensure it is accessible for testing.
04
Shut off the water supply to the backflow preventer and open all downstream valves to relieve pressure.
05
Attach the test kit to the backflow preventer and ensure it is tightly connected.
06
Open the test cocks on the backflow preventer, starting with the first zone and working your way through each zone.
07
Record the pressure readings indicated on the test kit for each zone.
08
Close the test cocks and remove the test kit.
09
Fill out the backflow preventer test report form with the recorded pressure readings and any additional information required.
10
Submit the completed form to the appropriate authority or organization responsible for backflow prevention.
11
Keep a copy of the test report form for your records.

Who needs backflow preventer test and?

01
Several individuals and businesses may require backflow preventer testing, including:
02
- Property owners with irrigation systems
03
- Municipalities and local governments
04
- Water supply companies
05
- Industries that handle hazardous materials
06
- Medical facilities and hospitals
07
- Commercial buildings and complexes
08
- Restaurants and food establishments
09
- Swimming pools and recreational facilities
10
- Any location where there is a risk of cross-contamination between potable and non-potable water sources.
11
It is important to consult local regulations and guidelines to determine specific requirements for backflow preventer testing in your area.
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A backflow preventer test is a procedure conducted to ensure that backflow prevention devices are functioning correctly to prevent contaminated water from flowing back into the potable water supply.
Typically, property owners with water systems that have backflow prevention devices are required to file backflow preventer tests, often mandated by local regulations.
To fill out a backflow preventer test form, one must include the device type, location, test results, tester's name, signature, and date of the test, ensuring all sections are completed accurately.
The purpose of a backflow preventer test is to verify that the device is effectively blocking any backflow into the drinking water supply, thereby protecting public health.
The information reported must typically include the type of device, model and serial numbers, test results, name and certification number of the tester, and the date of the test.
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