Onondaga County, NY · Onondaga County
Application for Approval of Backflow Prevention Devices
This application requests approval of backflow prevention devices and is completed by facility owners and their design engineers or architects.
At a glance
- Issued by
- City of Onondaga County · Onondaga County, Onondaga County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- onondaga.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this form to request approval for backflow prevention devices at a facility, including initial installations or replacements and new or existing services or buildings. It asks for facility, owner, device, water pressure, cost, hazard, and water supplier information, along with design professional details. Applicants must include plans, specifications, and an engineer’s report describing the project.
Who needs it
Facility owners seeking approval of backflow prevention devices complete the application with information from their design engineer or architect.
How to submit it
Submit the project first to the water supplier, which will forward it to the local public health engineer. Prepare the form in quadruplicate with four copies of all plans, specifications, and descriptive literature.
About notarization
This document is signed without a notary; the design engineer or architect must provide an original ink signature and seal on all copies.
How to submit this form
- 1
Download the Application
Download the application for approval of backflow prevention devices.
- 2
Complete the Form
Print or type the entries, complete the requested facility, owner, device, water pressure, cost, and hazard information, and obtain the required signatures.
- 3
Gather Supporting Materials
Include plans, specifications, and an engineer’s report describing the project, with four copies of all supporting materials.
- 4
Submit to the Water Supplier
Submit the project first to the water supplier, which will forward it to the local public health engineer.
Frequently asked questions
- Do I need a notary for the backflow prevention device application?
- No. The application does not require a notary. The design engineer or architect must provide an original ink signature and seal on all copies.
- How do I submit the backflow prevention device application?
- Submit the project first to the water supplier, which will forward it to the local public health engineer. Prepare four copies of the completed form and supporting materials.
- What must accompany the application?
- All applicants must include plans, specifications, and an engineer’s report describing the project in detail, along with four copies of those materials.
- What information does the application request?
- It asks for facility and owner details, device specifications, service and building counts, water pressure, estimated costs, hazard information, water supplier details, and design professional information.