Sample Test Backflow Letter.pdf

Sample Test Backflow Letter.docx 2017-Oct
Company Name Office Address
Mailing Address City, State Zip code
City, State Zip code Office phone: xxx-xxx-xxxx
Emergency Phone: xxx-xxx-xxxx
Fax: xxx-xxx-xxxx
Email: xxxxxxx@xxxx

Date

Customer Account #
Customer Name
Address
Address

RE: Reminder Notice - Test Premise Backflow Assembly

Dear Name:

As your water provider, we are required by the State to confirm that all required backflow
assemblies have been inspected by a state licensed tester. (Idaho Rules for Public Drinking
Water, IDAPA 58.01.08.552.06). State licensed backflow testers can be found in the phone
book or online by searching for “Backflow Protection.”

As the Assembly Owner, it is your responsibility to:
 Arrange to test your backflow assembly during the current irrigation season.
 Maintain and test your backflow assembly annually.
 Schedule and pay for the cost of this test.
 Ensure that the Company has received results within 15 days of the actual test.

Failure to test your backflow assembly each year will result in termination of service in
accordance with the Idaho Public Utilities Commission’s Utility Customer Relations Rules (IDAPA
31.21.01.303.01).

If you have already arranged to test your backflow assembly this year, please disregard this
notice and retain a copy of the test for your records.

Sincerely,

Name
Title