Live Oak, TX · Bexar County
Backflow Assembly Test Report
The Backflow Assembly Test Report records test and maintenance details for an assembly and is completed by the tester for submission to the City of Live Oak.
What this form is
The report documents backflow assembly test results, including pressure readings, check valve results, whether the assembly passed, and any repair or cleaning information. The form states it is required for all new installations, replacements, and removals. It also asks for assembly and service details, tester and company information, test kit details, and the tester’s signature.
Who needs it
A tester completing a backflow assembly test for a new installation, replacement, or removal submits this report to the City of Live Oak.
How to submit it
Return a legible and satisfactory report to the City of Live Oak, Texas, at 8001 Shin Oak, Live Oak, TX 78233; failed, incomplete, or illegible reports will not be accepted.
About notarization
The tester signs and dates this report without a notary; it does not specify any sworn or notarized attachment.
How to submit this form
- 1
Download The Report
Download the Backflow Assembly Test Report for the backflow assembly test.
- 2
Complete The Test Details
Fill in assembly, service, test result, company, tester, and test kit information.
- 3
Record Repairs Or Cleaning
If applicable, record repair or cleaning information in the remarks section.
- 4
Sign And Return The Report
Have the tester sign and return a legible, satisfactory report to the City of Live Oak at the address listed on the form.
Frequently asked questions
- What information does the Backflow Assembly Test Report request?
- It requests assembly and service details, test readings and results, repair or cleaning remarks, company and tester information, test kit details, and the tester’s signature.
- How do I submit the Backflow Assembly Test Report?
- Return a legible and satisfactory report to the City of Live Oak at 8001 Shin Oak, Live Oak, TX 78233. The form says failed, incomplete, or illegible reports will not be accepted.
- Do I need a notary for the Backflow Assembly Test Report?
- No. The tester signs and dates the report without a notary; the form does not specify any sworn or notarized attachment.