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This form serves as a certification for backflow devices installed at designated service addresses in compliance with the Safe Drinking Water Act as monitored by the SC Department of Health and Environmental
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How to fill out backflow device certification form

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How to fill out Backflow Device Certification Form

01
Obtain the Backflow Device Certification Form from your local regulatory authority or website.
02
Ensure you have the necessary information including the property address and owner's contact details.
03
Fill out the specific details of the backflow device including its type, manufacturer, and model number.
04
Provide documentation of any previous tests or certifications conducted on the device.
05
Complete the section for the tester's details, including their name, certification number, and contact information.
06
Review the form for accuracy and completeness before submission.
07
Submit the completed form to the appropriate regulatory authority by the specified deadline.

Who needs Backflow Device Certification Form?

01
Property owners with a backflow prevention device installed.
02
Businesses that utilize water systems with potential contamination risks.
03
Plumbing professionals who perform testing and certification of backflow devices.
04
Municipalities requiring compliance for public health and safety regulations.
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The Backflow Device Certification Form is a document that certifies that backflow prevention devices have been installed and are functioning properly in order to protect the public water supply from contamination.
Typically, property owners or managers who have installed backflow prevention devices are required to file the Backflow Device Certification Form, along with certified testers who perform the annual testing.
To fill out the Backflow Device Certification Form, you need to provide information such as the location of the device, the type of device, the test results, the name of the certified tester, and their certification number.
The purpose of the Backflow Device Certification Form is to ensure compliance with local and state regulations by verifying that backflow devices are routinely tested and maintained to prevent contamination of the drinking water supply.
The information that must be reported includes the address of the property, the type and serial number of the backflow prevention device, test results showing whether the device passed or failed, and the name and contact information of the tester.
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