Forney, TX · Kaufman County
Backflow Prevention Assembly Test and Maintenance Report
This report records backflow assembly testing and maintenance for a Forney business or resident and is completed by the certified tester.
What this form is
The report documents the test and maintenance of a backflow prevention assembly and must be completed for each assembly tested. It asks for the business or resident and assembly details, device type, test results, repairs, gauge information, and tester and firm details. A signed and dated original must be submitted to the Water System Official for the public water supplier’s records.
Who needs it
A certified tester completes this report for each backflow prevention assembly tested for a Forney business or resident.
How to submit it
Submit a signed and dated original to the Water System Official at P.O. Box 826, Forney, Texas 75126.
About notarization
This report is signed and dated without a notary; the tester certifies the test results, and no notarized attachment or related sworn step is listed.
How to submit this form
- 1
Download The Report
Download the Backflow Prevention Assembly Test and Maintenance Report PDF.
- 2
Complete The Report
Complete the form for each assembly tested, including assembly, test, repair, gauge, and tester details.
- 3
Sign And Date
Have the tester sign and date the report.
- 4
Submit The Original
Submit the signed and dated original to the Water System Official at P.O. Box 826, Forney, Texas 75126.
Frequently asked questions
- What is the Backflow Prevention Assembly Test and Maintenance Report?
- It records test and maintenance details for a backflow prevention assembly and is completed for each assembly tested.
- Who completes the backflow test report?
- A certified tester completes the report with assembly, test, repair, gauge, and tester details for a business or resident.
- Do I need a notary for the Backflow Prevention Assembly Test and Maintenance Report?
- No. The report is signed and dated without a notary; the tester certifies the test results, and no notarized attachment or related sworn step is listed.
- How do I submit the backflow test report?
- Submit a signed and dated original to the Water System Official at P.O. Box 826, Forney, Texas 75126.
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.