Yadkinville, NC · Yadkin County
Backflow Prevention Tester and Test Kit Information
Backflow testers provide their contact, certification, company, and test kit details to the Town of Yadkinville for its backflow program records.
What this form is
This form collects information about a backflow prevention tester and the test kit used for testing. The Town requires a copy of the tester’s certification certificate for its records, and the form lists approved test kits and the standards kits must meet. It also notes that testers should understand the Town’s Backflow Program and Ordinance.
Who needs it
Backflow prevention testers providing tester and test kit information to the Town of Yadkinville need this form.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
No notary is required; include a copy of the tester’s certification certificate, and the document identifies no sworn or notarized attachment.
How to submit this form
- 1
Download The Form
Download the Backflow Prevention Tester and Test Kit Information PDF.
- 2
Complete The Information
Fill in the tester, certification, company, and test kit details requested on the form.
- 3
Gather The Certificate
Include a copy of the tester’s certification certificate, which the Town requires for its records.
- 4
Submit To The Town
Submit the form to the city department named on it; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Backflow Prevention Tester and Test Kit Information form?
- No. This form does not require notarization. It asks for a copy of the tester’s certification certificate, but does not identify a sworn or notarized attachment.
- How do I submit the tester and test kit information?
- Submit the completed form to the city department named on the form. Check the city website for current contact details.
- What information does the form request?
- It requests tester contact and certification details, company information, and test kit manufacturer, type, serial number, and calibration date.
- What attachment does the Town require?
- The document says the Town requires a copy of the tester’s certification certificate for its records.