Submit a Backflow Report

For Certified Backflow Testers:

Submit your annual and post-repair backflow test results here. You must have a current certification on file with the District before submitting a report. Complete one report per assembly.

BACKFLOW REPORT SUBMISSION

Service Address (required)

Location of Assembly (required)

Reason for Test (required)

Tester Name (required)

Certification Number (required)

DOCUMENTS UPLOAD

Upload completed report (required)

CONFIRM & SUBMIT

Attestation (required)

I certify under penalty of perjury under the laws of the State of California that I personally performed this test using a gauge calibrated within the past 12 months, that I hold a current State Water Board–recognized certification, and that the backflow test report attached to this submission is true and accurate.

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