Before you print
Use this blank with your own notes, then compare it with your local program or water supplier instructions. For background on backflow, the EPA Cross-Connection Control Manual describes backflow as flow into the pipes of a potable water supply from a source other than the intended source, and backsiphonage as backflow caused by negative pressure in those pipes. Related pages: rpz testing procedure, field checklist, report guide, and pdf record.
What this blank is for
This page is for writing down the details you want to keep with your record. It is not a water supplier form, and it does not judge the readings you enter. The EPA manual also lists six basic means used against backflow: air gaps, barometric loops, atmospheric and pressure vacuum breakers, a double check with an atmospheric vent, double check valve assemblies, and reduced pressure principle devices.
Why RPZ notes matter
An EPA survey report describes a cross-connection as any actual or potential connection between a drinking water system and another supply or source that could contaminate it. The 2003 EPA manual says a reduced pressure principle assembly keeps the zone between its two checks at a lower pressure than the supply, opens a relief to atmosphere, and is furnished with test cocks and shutoff valves.
What Backflow Record stores
Backflow Record is an iPhone app for saving a backflow test report as a record the user fills in. It is not the test itself and it is not a water supplier form, so your notes stay separate from any local submission process.
A report in Backflow Record is a record you fill in. It is not a substitute for a licensed tester or for the form your water supplier requires. It does not report an inspection result, and it does not mean a plumbing rule was met.