Copperas Cove, TX · Coryell County
Backflow Prevention Tester Registration Form
Backflow prevention testers use this form to register or renew registration with the city and provide tester, employer, and testing gauge information.
What this form is
This form is for new or renewal registration as a backflow prevention tester. It asks for the tester’s contact and license details, employer information, and testing gauge make, model, serial number, and calibration expiration. The form says registration may be void if it is not completed fully and lists documents to include, such as tester accreditation and gauge calibration reports.
Who needs it
Backflow prevention testers seeking new or renewed registration with the city should complete this form and provide the listed supporting documents.
How to submit it
Email the completed form and all required documents and reports to [email protected], as directed on the form.
About notarization
This form is signed without a notary; the signer certifies the information is true and correct, then prints their name and dates the form.
How to submit this form
- 1
Download The Form
Download the Backflow Prevention Tester Registration Form PDF.
- 2
Complete The Form
Select new or renewal registration and complete the tester, employer, and testing gauge sections.
- 3
Gather Required Documents
Include the listed accreditation, gauge calibration report, driver’s license, and any other licenses pertaining to plumbing, fire lines, and irrigation.
- 4
Sign And Date
Certify that the information is true and correct, print your name, and provide your signature and date.
- 5
Email The Materials
Email the completed form and all documents and reports to [email protected].
Frequently asked questions
- Do I need a notary for the Backflow Prevention Tester Registration Form?
- No. The form has a signature and date field but no notary block. The signer certifies that the information is true and correct, prints their name, and dates the form.
- How do I submit the Backflow Prevention Tester Registration Form?
- Email the completed form and all documents and reports to [email protected]. The form directs testers to send registration materials to this email address.
- What supporting documents does the form list?
- The form lists a copy of TCEQ backflow tester accreditation, a current accuracy test or calibration report for each gauge kit in use, a current driver’s license copy, and copies of other related licenses.
Need something notarized?
This Backflow Prevention Tester Registration Form doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.