Manvel, TX · Brazoria County
Backflow Prevention Assembly Certified Test Report
Certified testers complete this report for each backflow prevention assembly tested and submit the signed, dated original to the City of Manvel.
What this form is
This report records test results and maintenance for a backflow prevention assembly and certifies that it operates within acceptable parameters. A report is required for each assembly tested; the form says backflows must be inspected annually and a signed copy submitted to the City of Manvel. It asks for water system, customer, assembly, tester, test gauge, test results, and repair information.
Who needs it
Certified testers who test backflow prevention assemblies must complete a separate report for each assembly and submit it to the City of Manvel.
How to submit it
Submit the signed and dated original to the City of Manvel for record keeping purposes; the form also says to submit a signed copy of the report to the city.
About notarization
This report is signed and dated by the certified tester without a notary; the signer just signs and dates the report.
How to submit this form
- 1
Download the Report
Download the Backflow Prevention Assembly Certified Test Report.
- 2
Complete the Report
Complete a report for each assembly tested, including assembly details, test results, and certified tester information.
- 3
Sign and Date
The certified tester certifies the information and signs and dates the report.
- 4
Submit to the City
Submit the signed and dated original to the City of Manvel for record keeping purposes.
Frequently asked questions
- Who completes the Backflow Prevention Assembly Certified Test Report?
- The certified tester completes the report for each assembly tested, including the test results, tester details, and certification.
- Do I need a notary for the Backflow Prevention Assembly Certified Test Report?
- No. The report is signed and dated by the certified tester without a notary.
- How do I submit the Backflow Prevention Assembly Certified Test Report?
- Submit the signed and dated original to the City of Manvel for record keeping. The form also says to submit a signed copy of the report to the city.