Do I need a notary for the Backflow Prevention Assembly Test Results?

No. The document has signature and date fields for the tester and owner or officer but no notary block. It does not mention a notarized or sworn attachment.

How do I submit the Backflow Prevention Assembly Test Results?

The form lists fax number 419-946-8111 and email mtgileadh2o@myomnicity.com. It also says to provide a copy of the test results to the owner or person in charge of the premises.

What information does the report ask for?

It asks for facility and contact details, assembly and installation information, test results, repairs and materials used, tester certification, and signatures and dates.

What does the form say about failed reports and repairs?

The form states that failed, illegible, or incomplete reports will not be accepted and that all repairs must be completed within ten days.

Mount Gilead, OH · Morrow County

No notary required

Backflow Prevention Assembly Test Results

This report records backflow assembly test results for a tester to complete and send to the Village of Mount Gilead, with a copy provided to the property owner or person in charge.

What this form is

This report documents the test, condition, and repair information for a backflow prevention assembly at a facility. The tester records facility and assembly details, test results, repairs, and certification information; the owner or officer also signs and dates the report. The form states that failed, illegible, or incomplete reports will not be accepted and that repairs must be completed within ten days.

Who needs it

A backflow tester completing assembly test results for a Mount Gilead facility uses this report and provides a copy to the owner or person in charge.

How to submit it

Fax the completed results to 419-946-8111 or email them to [email protected]. Provide a copy of the test results to the owner or person in charge of the premises.

About notarization

This document is signed without a notary; the tester and owner or officer sign and date it, and no notarized or sworn attachment is mentioned.

How to submit this form

1
Download The Report
Download the Backflow Prevention Assembly Test Results PDF for Mount Gilead.
2
Complete The Test Report
Enter the facility, assembly, installation, test, and repair details, then complete the certification and signature fields.
3
Provide A Copy
Give a copy of the test results to the owner or person in charge of the premises, as the form instructs.
4
Send The Results
Fax the report to 419-946-8111 or email it to [email protected].

Frequently asked questions

Do I need a notary for the Backflow Prevention Assembly Test Results?: No. The document has signature and date fields for the tester and owner or officer but no notary block. It does not mention a notarized or sworn attachment.
How do I submit the Backflow Prevention Assembly Test Results?: The form lists fax number 419-946-8111 and email [email protected]. It also says to provide a copy of the test results to the owner or person in charge of the premises.
What information does the report ask for?: It asks for facility and contact details, assembly and installation information, test results, repairs and materials used, tester certification, and signatures and dates.
What does the form say about failed reports and repairs?: The form states that failed, illegible, or incomplete reports will not be accepted and that all repairs must be completed within ten days.

Need something notarized?

This Backflow Prevention Assembly Test Results doesn’t need a notary — but if you have another Mount Gilead form that does, a commissioned online notary can help.