Do I need a notary for the Backflow Prevention Assembly Test and Maintenance Report?

No. The report does not require notarization; the licensed tester signs and dates it to certify the information is true at the time of testing.

When is a backflow test report required?

The report says it must be completed for each assembly tested. A signed and dated original must be submitted to the public water supplier for recordkeeping.

What information does the report request?

It requests service and facility details, assembly type and specifications, test results, repairs and materials used, gauge information, and company and licensed tester details.

Prosper, TX · Collin County

No notary required

Backflow Prevention Assembly Test and Maintenance Report

Licensed testers use this report to document testing and maintenance of a backflow prevention assembly and submit the signed original for recordkeeping.

What this form is

The report records test results and maintenance for each backflow prevention assembly tested, and certifies that the assembly is operating within acceptable parameters. It asks for service and facility details, assembly information, test results, repairs, gauge information, and licensed tester and company details. A signed and dated original must be submitted to the public water supplier for recordkeeping.

Who needs it

A licensed tester completing a test of a backflow prevention assembly must fill out and submit a separate report for each assembly tested.

How to submit it

Submit the signed and dated original to the public water supplier at the Public Works Department, PO Box 307, Prosper, TX 75078.

About notarization

This report does not require a notary; the licensed tester signs and dates the report to certify the information is true at the time of testing.

How to submit this form

1
Download The Report
Download the Backflow Prevention Assembly Test and Maintenance Report.
2
Complete The Test Details
Complete a report for each assembly tested, including assembly, test, repair, gauge, company, and licensed tester information.
3
Sign And Date The Report
The licensed tester signs and dates the report to certify it is true at the time of testing.
4
Submit The Original
Send the signed and dated original to the public water supplier at the Public Works Department, PO Box 307, Prosper, TX 75078.

Frequently asked questions

Do I need a notary for the Backflow Prevention Assembly Test and Maintenance Report?: No. The report does not require notarization; the licensed tester signs and dates it to certify the information is true at the time of testing.
How do I submit the backflow test report?: Submit a signed and dated original to the public water supplier at the Public Works Department, PO Box 307, Prosper, TX 75078.
When is a backflow test report required?: The report says it must be completed for each assembly tested. A signed and dated original must be submitted to the public water supplier for recordkeeping.
What information does the report request?: It requests service and facility details, assembly type and specifications, test results, repairs and materials used, gauge information, and company and licensed tester details.

Need something notarized?

This Backflow Prevention Assembly Test and Maintenance Report doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.