Consumer Services & Outreach
Official Test Forms
- Annual Backflow Prevention Device Test and Maintenance Report Form (PDF 34 kb)
- Annual form required to be filed with the cross-connection office
- Backflow Assembly Installation Form (PDF 8 kb)
- New construction/major renovation
- Cross-Connection Sample Survey Form (PDF 55 kb)
- Existing building
- Example of an Annual Test & Inspection Tag (PDF 36 kb)
- Suggested information for assembly tags