Checklist: fields to write down

This backflow test log template is a checklist of fields. Tick or type them in the browser. Nothing is uploaded. The list is not a water supplier form, and it does not tell you whether an assembly met a manual.

This backflow test log template is a checklist of fields. Tick or type them in the browser. Nothing is uploaded. The list is not a water supplier form, and it does not tell you whether an assembly met a manual.

How to use it

Use the checklist to capture the details you want to keep in one place, then compare your notes with your own report record. If you want more context, see assembly record, backflow report form guide, and blank record tool. Backflow Record is meant to store the record you fill in, not to send a supplier form.

What this checklist is for

It helps you write down the fields that matter on a backflow report record, so you can organize the information before you save it. 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.

When to use Backflow Record

Use Backflow Record if you want a place to keep your own report record on iPhone. A web version and Android are planned, and you can join the waitlist from get the app.

This form stays in the tab. It is not uploaded.

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.