Ovilla, TX · Ellis County
Backflow Prevention Assembly Test and Maintenance Report
Certified testers use this report to record backflow prevention assembly test results, maintenance, and certification details for a water service.
What this form is
This report records testing and maintenance of a backflow prevention assembly and certifies that it operates within acceptable parameters. It asks for the water system name and ID, service location, assembly type and identifying details, test results, repairs and materials used, and information about the firm and certified tester. The document does not state when the report must be submitted.
Who needs it
A certified tester completing a backflow prevention assembly test and maintenance report for an irrigation, domestic, or fireline service needs this form.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This report is signed and dated without a notary; the signer certifies the information, and no notarized or sworn attachment is mentioned.
How to submit this form
- 1
Download the Report
Download the Backflow Prevention Assembly Test and Maintenance Report.
- 2
Complete the Report
Mark the service type and fill in the service, assembly, test, repair, firm, and certified tester details.
- 3
Review and Sign
Certify the information, then enter the date and required firm and tester information.
- 4
Submit to the City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What does the Backflow Prevention Assembly Test and Maintenance Report record?
- It records the service location, assembly type and identifying details, test results, repairs and materials used, and firm and certified tester information.
- Who completes the backflow report?
- The form includes fields for a certified tester, tester number, firm details, test results, and a certification that the information is true.
- Do I need a notary for the Backflow Prevention Assembly Test and Maintenance Report?
- No. The report is signed and dated without a notary; it includes the signer's certification, and no notarized or sworn attachment is mentioned.
- How do I submit the backflow report?
- Submit it to the city department named on the form; check the city website for current contact 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.