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Módulo 9 de 10 160m 12 exam Qs

Test Reporting & Documentation

Test form requirements, gauge serial numbers, recording readings, repair documentation, and tester certification.

  • Complete a backflow test report with all required information
  • Record gauge serial numbers, test readings, and pass/fail results
  • Document repairs with manufacturer part numbers and retest results
  • Explain ASSE 5110 certification and renewal requirements
  • Describe post-test procedures including test cock closure and gauge care

Lección 1

Test Form Requirements & Data Recording

What Goes on the Test Report

Every backflow test must be documented on an official test report form. Most water utilities provide their own forms, but all forms require the same core information. The test report is a legal document that certifies the assembly was tested and records its condition.

Required information on every test report:

Category Required Data
Assembly info Manufacturer, model, serial number, size
Location Address, installation location on property
Test data Gauge serial number, test readings for each component
Results Pass or fail for each component, overall pass/fail
Tester info Tester name, certification number, signature
Date Date of test
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Gauge Serial Number

The gauge serial number must be recorded on every test report. This links the test results to a specific calibrated instrument and provides traceability. If a question asks what must appear on a test form, the gauge serial number is a frequently tested answer.

Recording Test Readings

Test readings must be recorded exactly as measured:

  • RPZ tests - record relief valve opening point, Check #2 differential, Check #1 differential
  • DCVA tests - record Check #1 differential and Check #2 differential
  • PVB tests - record check valve differential and air inlet opening point

Readings are recorded in psi to the nearest 0.1 psi (one decimal place). If a reading fluctuates, record the lowest stable reading observed.

0.1 psi
Recording Precision
Lowest Stable
Reading to Record if Fluctuating
Both
Initial and Repair Readings Required

Submitting Reports

Completed test reports must be submitted to the water utility or authority having jurisdiction within the timeframe specified by local regulations (often 10-30 days after testing). Many utilities now accept electronic submissions. The tester must retain copies of all test reports for their own records.

Key Takeaway

Every test report must include the gauge serial number, exact test readings to 0.1 psi, assembly identification, and the tester's certification number and signature. Reports must be submitted to the water utility within the required timeframe.