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Backflow Prevention Assembly Test Report Form (PDF) All testable backflow devices are to be tested upon installation, and tested thereafter at a frequency to be determined by the DPW. LEAKED B320 Water services will not be disrupted. Housing. RBA & Testable Backflow - City of Minneapolis If not an annual Test, please select one of the following: New Assembly Remove Assembly Replace Assembly. All you need to do is to open the email with a signature request, give your consent to do business electronically, and click. A standard IT Service Form, useful for businesses that deal with everyday IT related tasks which can be used as an IT service ticket template that allows file attachment and provides an area for further information. While we don't test assemblies, we do keep a record of where backflow prevention assemblies are installed. 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CCC Program Mgr. 430$5I#Eo Test reports are no longer accepted through in-person drop off, email, fax or postal mail. An employee timesheet template is used by employers to track the hours that their employees work. Backflow Prevention Assembly Test Data and Maintenance Report MO 780-0804 | Missouri Department of Natural Resources DROUGHT ALERT - Drought conditions persist in 58% of Missouri, including severe drought conditions in less than 2% of the state Backflow Prevention Assembly Test Data and Maintenance Report MO 780-0804 of 0 PSID PSID A backflow testing report will document the type of testing conducted and the status of the pipes. Stick to these simple instructions to get Backflow Test Report Form ready for sending: Submitting Backflow Test Report Form does not need to be perplexing anymore. 0000004918 00000 n If you do not own a backflow device and mistakenly received a letter, please disregard it. Backflow Assembly Test Report Forms 2014-2023 - signNow No-Flow Validation Test - Concerns NEWWA Backflow Test Report Form (MS Word Format) NEWWA Backflow Test Report Form (Writable PDF Format) Upcoming Courses & Brochures Click here to view all upcoming courses online. After testing is complete, your certified backflow tester will put your sticker labels on your report and mail the completed test report to us at: Portland Water Bureau Otherwise, the tester may submit results for any backflow assembly test by using the Backflow Maintenance Report. Submitting backflow assembly test reports | Portland.gov In case you necessity to correct something, our online editor and its wide range of instruments are at your disposal. Ideal for employers meeting Santa Clara County requirements. An asset disposal form is a form used to document the disposal process of assets. Sign in to your account, upload the Backflow Assembly Test Report Forms, and open in the editor. This report should help backflow assembly testers (BATs) and water systems comply with the minimum test report content requirements in the Operator Certification Rule. Telephone: 416-394-8888 (Voicemail Only) Email: [email protected]. This test form can be used to streamline the test and maintenance process. If you have any questions regarding theBackflow Prevention Program, please contact [email protected]. RUBBER KIT a private or public potable water source shall be connected to the water source through a reduced pressure principle backflow prevention assembly as defined in 344.50 of this title (relating to Backflow Prevention Methods); and . 52}pkg*:h It is your responsibility for arranging for a state-certified contractor to test your assembly. 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