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BACKFLOW PREVENTION ASSEMBLY TEST AND MAINTENANCE REPORT The following form must be completed for each assembly tested. A signed and dated original must be submitted to the public water supplier for
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How to fill out backflow prevention assembly testing-form

01
Start by gathering all necessary information including the name and contact information of the property owner, the location of the backflow prevention assembly, and the date of the test.
02
Fill out the top portion of the form with this information.
03
Check the appropriate boxes to indicate the type of backflow prevention assembly being tested.
04
Record the results of the test accurately, including any failures or deficiencies.
05
Sign and date the form to certify that the test was performed accurately and in compliance with regulations.
06
Submit the completed form to the appropriate authorities for review and approval.

Who needs backflow prevention assembly testing-form?

01
Backflow prevention assembly testing-form is typically needed by property owners or managers of buildings where backflow prevention assemblies are installed.
02
It is also required by local authorities and water utility companies to ensure that backflow prevention assemblies are functioning properly and in compliance with regulations.
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The backflow prevention assembly testing form is a document used to report the results of tests conducted on backflow prevention devices to ensure they are functioning properly and preventing contamination of the public water supply.
Owners of properties equipped with backflow prevention assemblies are required to file the testing form, along with certified testers who conduct the assessments.
To fill out the backflow prevention assembly testing form, one should provide details such as the property address, the type and serial numbers of the assemblies, the test results, and the tester's information including certification.
The purpose of the form is to ensure that backflow prevention assemblies are functioning effectively, thus protecting the potable water supply from contamination.
The form must report the property address, type of backflow assembly, test results, any repairs made, the date of the test, and the tester's name and certification details.
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