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Backflow Prevention Device
Test and Maintenance Report
Business Name:Site Phone:Site Address:City:ZIP:Assembly Location:
Internal:(Please use dimensions and references Lot lines, Property Lines, Curb
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How to fill out backflow prevention device test

How to fill out backflow prevention device test
01
Turn off the water supply upstream of the backflow prevention device.
02
Open the test cocks on the device to relieve pressure.
03
Insert a testing gauge into the test cock opening.
04
Record the initial pressure reading on the gauge.
05
Close the test cocks and slowly reopen the water supply.
06
Monitor the gauge for any pressure changes, indicating a faulty backflow prevention device.
07
Record the final pressure reading and compare it to the initial reading.
Who needs backflow prevention device test?
01
All property owners or managers of buildings with potential cross-connections to the public water supply need to have a backflow prevention device test.
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What is backflow prevention device test?
A backflow prevention device test is conducted to ensure that devices installed to prevent the reverse flow of contaminated water into a potable water supply are functioning correctly.
Who is required to file backflow prevention device test?
Typically, property owners or managers of premises that have backflow prevention devices installed are required to file the test results with the local water authority or regulatory agency.
How to fill out backflow prevention device test?
To fill out a backflow prevention device test form, you need to provide details such as the location of the device, the type of device, results of the test, the tester's certification number, and the date of testing.
What is the purpose of backflow prevention device test?
The purpose of the backflow prevention device test is to verify the effectiveness of the device in stopping contaminants from being siphoned into the drinking water supply, thus ensuring public health and safety.
What information must be reported on backflow prevention device test?
The information that must be reported includes the location of the device, the test results, the type of device, the name and certification number of the tester, and the date the test was performed.
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