Hinesville, GA · Liberty County
Backflow Prevention Device Test Data and Maintenance Report
This report records backflow prevention device test results and maintenance details for account holders and testers submitting information to Hinesville.
What this form is
Use this report to document testing and maintenance for a backflow prevention device. It requests account and service location details, device and test-kit information, test results, repairs, calibration details, and tester and certification information. The form directs the completed report to Hinesville’s Department of Inspections.
Who needs it
Account holders and testers use this report to provide Hinesville with backflow prevention device test and maintenance information.
How to submit it
Return the report to the City of Hinesville Department of Inspections, 115 East M.L. King, Jr. Drive, Hinesville, GA 31313. The form lists (912) 876-4147.
About notarization
This report is completed without a notary; it contains a certification that the report is true, but no notarized or sworn attachment is identified.
How to submit this form
- 1
Download The Report
Download the Backflow Prevention Device Test Data and Maintenance Report.
- 2
Complete The Report
Fill in the account, service, device, test, repair, calibration, tester, and certification information requested.
- 3
Review The Test Details
Check the recorded device test results and maintenance details before returning the report.
- 4
Return The Report
Return it to the Department of Inspections at the address printed on the form.
Frequently asked questions
- What information does the backflow test report request?
- It requests account and service location details, device and test-kit information, test results, repairs, calibration details, and tester and certification information.
- How do I submit the backflow test report?
- Return the completed report to Hinesville’s Department of Inspections at 115 East M.L. King, Jr. Drive, Hinesville, GA 31313. The form lists (912) 876-4147.
- Do I need a notary for this report?
- No. The report contains a certification that the report is true, but no notarized or sworn attachment is identified.
Need something notarized?
This Backflow Prevention Device Test Data and Maintenance Report doesn’t need a notary — but if you have another Hinesville form that does, a commissioned online notary can help.