Compliance checklist
Backflow preventer: annual test record
The annual cross-connection test the water authority requires: device pressures, valve checks, tester credentials, and a signature.
10 steps · 2 photos asked for · 2 readings recorded
Every step, in order
This is what a technician is asked, one question at a time, on the phone.
- 1
Scan the device tag
Scan the tag · needed
- 2
Tester certification number
Your backflow tester license / certification ID.
Written answer · needed
- 3
Check valve #1 differential
Reading in psid · needed
- 4
Check valve #2 holding tight?
Yes or no · needed
- 5
Photograph the failing reading
Photo · needed
- 6
Backflow preventer FAILED its annual test. Repair and retest required.
Tell somebody · needed
- 7
Relief valve opening point
Reading in psid · needed
- 8
Photo of the test gauge on the device
Photo · needed
- 9
Tester signature
Signing certifies the readings above are accurate.
Signature · needed
- 10
Notes
Written answer · needed
What this looks like on a phone
The checklist above is a workflow, not a document. Which changes four things.
- One question at a time, so nothing is skipped
- The tag is scanned, so the record cannot be filed against the wrong unit
- A failed check raises tracked work with the photo already attached
- The report exists the moment the last question is answered
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