Backflow Test Submission
Submit the Backflow Prevention Assembly Test Results
Enter Your TID Number IN CAPS (TID777777)
*
E-mail
(If your email has changed please enter the new email)
Phone Number
(If your telephone number has changed please enter the new number)
Date Test Performed
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-
Month
-
Day
Year
Date
Backflow Serial Number
*
If you are unable to locate the backflow serial number DO NOT PROCEED. YOU MUST CONFIRM YOU HAVE THE CORRECT BACKFLOW DEVICE BEFORE TESTING OR RESULTS WILL NOT BE ACCEPTED.
Meter Number
*
If you are unable to locate the meter number DO NOT PROCEED. YOU MUST CONFIRM YOU HAVE THE CORRECT METER BEFORE TESTING OR RESULTS WILL NOT BE ACCEPTED.
Meter Read at time of Test
*
Pass / Needs Repair / Fail
*
Please Select
Passed
Failed
Additional Information
Please do not exceed 200 words.
YOUR CERTIFICATION HAS EXPIRED! PLEASE UPDATE YOUR CERTIFICATION BEFORE SUBMITTING RESULTS
Upload Test Report
*
Upload a File
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Choose a file
Each test must have a separate submission. If you have multiple tests to submit, please submit them separately with the corresponding serial number, meter number and meter read information. Bulk uploads will not be accepted.
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Internal Acces Code
For Internal Use Only
Verified
Denied
Needs Follow Up
Reson for Denial or Follow Up
Company Name
*
Company Name Responsible for Testing
Tester Name
*
First Name
Last Name
Tester Certification #
*
THIS IS REQUIRED - ALl Backflow Testers must be approved by AWWA or Riverside County.
Certificate Expiration Date
*
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Month
-
Day
Year
Date
Validation Field
Should be Empty: