VA Backflow Assembly Test Report - James City 2023-2026 free printable template

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Este formulario se utiliza para documentar la prueba de dispositivos de retroceso, asegurando que cumplen con los códigos y regulaciones federales, estatales y locales.

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How to fill out VA Backflow Assembly Test Report

How to fill out backflow assembly test report

01

Obtain the backflow assembly test report form from your local water authority or regulatory body.

02

Fill in the date of the test at the top of the report.

03

Enter the name and contact information of the person completing the test.

04

Provide the location of the backflow assembly, including the address and specific site details.

05

Record the manufacturer's name, model number, and serial number of the backflow assembly.

06

Indicate whether the assembly is a reduced pressure zone (RPZ), double check (DC), or a pressure vacuum breaker (PVB).

07

Conduct the test according to the required procedures for the type of assembly being tested.

08

Fill in the results for each test conducted, including the readings for the relief valve, check valves, and any other required measurements.

09

Document any repairs or maintenance performed during the testing process.

10

Sign and date the report, and submit a copy to the appropriate water authority.

Who needs backflow assembly test report?

01

Property owners with backflow assemblies on their premises.

02

Commercial businesses that have water systems requiring backflow prevention.

03

Plumbers and contractors responsible for installing or maintaining backflow devices.

04

Local water authorities or regulatory agencies tracking compliance with backflow prevention regulations.

05

Health departments concerned about public safety regarding water quality.

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What is backflow assembly test report?

A backflow assembly test report is a document that certifies the testing and maintenance of backflow prevention devices to ensure they are functioning properly to prevent contaminated water from entering the public water supply.

Who is required to file backflow assembly test report?

Property owners, plumbing contractors, or certified backflow testers are typically required to file backflow assembly test reports with local water authorities or health departments.

How to fill out backflow assembly test report?

To fill out a backflow assembly test report, include the name and address of the property, details of the backflow prevention device, test results, tester's information, and any repairs or maintenance performed.

What is the purpose of backflow assembly test report?

The purpose of the backflow assembly test report is to ensure compliance with safety regulations and to verify that backflow prevention devices are operational, thereby protecting the drinking water supply from contamination.

What information must be reported on backflow assembly test report?

The report must include the name and address of the property, type of backflow prevention assembly, test results for each valve, date of test, tester's details, and any maintenance or repair actions taken.

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