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BACKFLOW PREVENTION ASSEMBLY TEST & MAINTENANCE FORM THIS FORM MUST BE COMPLETED BY A CERTIFIED TESTER 1. GENERAL INFORMATION NAME OF FACILITYSERVICE ADDRESSASSEMBLY LOCATIONHAZARD ID #MANUFACTURERSERVICE

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How to fill out backflow prevention assembly test

01

Turn off the water supply to the backflow prevention assembly.

02

Open the test ports and test cocks on the assembly.

03

Use a backflow test kit to conduct the test according to manufacturer's instructions.

04

Record the test results on an official backflow prevention assembly test form.

05

Submit the test form to the appropriate authorities for review and filing.

Who needs backflow prevention assembly test?

01

Anyone responsible for maintaining a water supply system, such as property owners, landlords, and water utility companies, needs to perform regular backflow prevention assembly tests to ensure the safety of the water supply.

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What is backflow prevention assembly test?

A backflow prevention assembly test is a procedure conducted to ensure that backflow prevention devices are functioning correctly, preventing contaminated water from flowing back into the potable water supply.

Who is required to file backflow prevention assembly test?

Typically, property owners or plumbing contractors are required to file backflow prevention assembly tests, especially if they have installed backflow prevention devices in their water systems.

How to fill out backflow prevention assembly test?

To fill out a backflow prevention assembly test, one must complete the specific form provided by local authorities, detailing the test date, device information, results of the test, and any corrective actions taken if necessary.

What is the purpose of backflow prevention assembly test?

The purpose of a backflow prevention assembly test is to ensure the safety of potable water by verifying that backflow prevention devices are working properly and preventing contamination from non-potable sources.

What information must be reported on backflow prevention assembly test?

The report must include information such as the type of backflow prevention device, test date, results (pass or fail), name of the tester, and any repairs or maintenance performed on the device.

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