Overton, TX · Rusk County
Backflow Test Report Form
Certified testers use this form to report a backflow assembly test for a property owner, business, or other device location in Overton.
What this form is
Use this form to report a new assembly, an annual test, or a replaced assembly, and to record the device, test results, and any repairs. The form says commercial backflow devices must be tested annually, failed non-repairable device reports must be submitted to the city, and a permit is required before installing a replacement device.
Who needs it
Certified testers completing a backflow assembly test for a residential, commercial, or fire sprinkler device use this report.
How to submit it
Annual test reports can be mailed or brought to the office at 1200 S. Commerce St., P.O. Drawer D, Overton, TX 75684. Inspections require 24-hour notice.
About notarization
No notary is required; the certified tester signs and dates the report, and a replacement device requires a permit before installation.
How to submit this form
- 1
Download The Form
Download the Backflow Test Report Form PDF.
- 2
Complete The Report
Enter the property, assembly, test, and certified tester details, including test results and any repairs.
- 3
Check For Required Steps
For a replacement device, obtain a permit before installation. Inspections require 24-hour notice.
- 4
Submit The Report
Mail or bring annual test reports to the city office at 1200 S. Commerce St., P.O. Drawer D, Overton, TX 75684.
Frequently asked questions
- What does the Backflow Test Report Form record?
- It records the assembly and property details, test date and results, certified tester information, and any repairs or materials used.
- Who uses the Backflow Test Report Form?
- Certified testers use the form to report tests for residential, commercial, and fire sprinkler backflow assemblies.
- Do I need a notary for the Backflow Test Report Form?
- No. The certified tester signs and dates the report. A replacement backflow device requires a permit before installation.
- How do I submit the Backflow Test Report Form?
- Annual reports can be mailed or brought to the office at 1200 S. Commerce St., P.O. Drawer D, Overton, TX 75684. Inspections require 24-hour notice.
Need something notarized?
This Backflow Test Report Form doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.