Backflow Compliance Survey

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Backflow

Backflow Compliance Survey

Name on Account (required)

Contact (Property Mgr)

Email (required)

Service Address (required)

Pressurized Irrigation (if no, there is no futher action required) (required)

YES

NO

UNSURE

Existing Backflow Assembly/Device (if yes, book appointment with local tester) (required)

YES

NO

UNSURE

Appointment Needed (if UNSURE or NO on Existing Backflow)

YES

NO

Date & Time Available for Appointment to Determine if there is an EXISTING Backflow Assembly (M-Th 7 am - 4 pm)

2nd Choice

3rd Choice

No Existing Backflow

Will Install in 2025

Will Install in 2026

Extension Needed beyond 2026

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Image showing approved and not approved backflow devices for landscape irrigation with installation guidelines.

TYPES OF BACKFLOW DEVICES

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