Stampario
Try it free
Stampario for backflow testers

Backflow test reports done at the assembly, not at the kitchen table

Enter check valve and relief readings on your phone, get the signature, and send the test report before you pull away. Every assembly keeps its own test history, and next year’s retest shows up on your call list.

Try it with your logoFree backflow test report form
5 reports a month freeYour logo and stampCustomer signs on your phone
Backflow Prevention Assembly Test Report example, page 1
Backflow Prevention Assembly Test Report · exampleOpen the PDF
What changes

Three things you stop doing

The same form, every assembly, every year

Make, model, serial, size and location are carried over from last year’s test. You only enter the new readings.

Retests slip through the cracks

Each assembly gets a 12-month cycle. Forty-five days before it is due, the customer lands on your call list with the contact’s number, ahead of the utility’s own 30-day notice.

Test kit calibration on every report

Your certification number, test kit serial and last calibration date print on every report automatically, so a purveyor never sends one back for a missing field.

On the report

Backflow Prevention Assembly Test Report

The template your account starts with. Switch off any line you don’t use and add your own.

  1. 01Reason for test
  2. 02Replaced assembly serial #
  3. 03Water purveyor
  4. 04Water account / meter #
  5. 05Meter reading
  6. 06Utility device / hazard #
  7. 07Type of service
  8. 08Make & model
  9. 09Assembly type
  10. 10Serial number
  11. 11Size
  12. 12Location of assembly
  13. 13Bypass meter reading / serial
  14. 14Line pressure
  15. 15Line pressure stable
  16. 16Shut-off valve #1
  17. 17Shut-off valve #2
  18. 18Check valve #1
  19. 19Relief valve opened at
  20. 20Check valve #2
  21. 21Air inlet opened at
  22. 22Check valve held at
  23. 23Check valve #1
  24. 24Check valve #2
  25. 25Relief valve did not open
  26. 26Air inlet opened fully
  27. 27Initial test result
  28. 28Repairs and parts
  29. 29Repair details
  30. 30Check valve #1
  31. 31Relief valve opened at
  32. 32Check valve #2
  33. 33Air inlet opened at
  34. 34Check valve held at
  35. 35Retest result
  36. 36Tester certification #
  37. 37Certification expires
  38. 38Test kit
  39. 39Test kit serial
  40. 40Test kit calibration date
  41. 41Results filed with the utility on
  42. 42Notes & recommendations
Lists ready on day one

Backflow assembly models

Watts 909 · RPWatts LF009 · RPWatts 007 · DCFebco 860 · RPFebco 765 · PVBWilkins 975XL2 · RPWilkins 720A · PVBZurn 375 · RP

Backflow test kits

Watts TK-DPMid-West 845-5Apollo TK-DP

Anything a technician types that is not on the list is added for next time.

Recurring work

Annual test per assembly by default, plus tests after installation, repair or relocation. Reminder 45 days before the due date.

Default: every 12 months · remind 45 days before · change per customer

Service due

The call list builds itself

Every customer on a cycle shows up before they are due, with the contact’s name and number. Call, book, mark it booked, and it leaves the list.

Service due list with overdue and upcoming customers
Rules & filing

What to know for backflow testing

Requirements vary by state, city and the code edition your authority having jurisdiction uses. This is a starting point, not legal advice.

  • Most water purveyors require an annual test by a certified tester and a report within 7–30 days. Some accept email or mail; others use a portal (BSI Online, VEPO, SwiftComply, Tokay). Check what your purveyor accepts.
  • The report includes the fields found on typical purveyor forms: assembly type, make, model, serial, size, location, initial test readings, repairs, retest and tester certification.
  • Where your purveyor requires its own form or portal, you still send the customer a signed copy and keep the history in one place.
Backflow testing requirements: how often and what the report needs →
Blank Backflow test report form
Free download

Backflow test report form (PDF)

A printable blank version of this report for the truck. No email required.

Get the template →
Questions

Backflow testers ask

Does this replace filing in BSI Online or VEPO?

Not yet. Where your purveyor requires a portal, you still file there. The app gives you the readings in one place to copy over, sends the customer their signed copy, and remembers the next test date.

Can I test several assemblies at one address?

Yes. Each assembly is its own unit with its own serial, test history and 12-month cycle, so a property with an irrigation PVB and a fire-line RP shows both.

Which assembly types are supported?

RP, DC, PVB and SVB, with the readings that apply to each type. The model list already includes common Watts, Febco, Wilkins, Zurn and Ames assemblies, and anything you type is added for next time.

What does it cost?

Free for 5 reports a month. Pro is $29 a month for unlimited reports and automatic reminder emails; Team is $69 a month for 3 field technicians. Every account gets 14 days of Pro starting with the first report, no card needed.

Other trades
HVAC contractorsPlumbersElectriciansPest control companiesFire extinguisher companiesHood cleaning companies

Send your next backflow testing report from the job

Free for 5 reports a month. No card. Your logo on every PDF from the first one.

Try it freeFree PDF templates