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Backflow Assembly Testers

If you would like to be added to our approved Backflow Assembly Tester list, please fill out the form below. 

Company Name:*
Tester Name:*
Tester Certification Number:*
Street Address:*
Zip Code:*
Contact Phone:*
Did you test under the 10th edition?:*
If no, what edition did you test under?:
Do you have a minimum number of tests in a day?:*
If yes, what is your minimum?:
Verify you are willing to travel to the Lake Cushman area.:*
Attach a copy of your current BAT certification.:
Attach a copy of your current calibrations.:

* indicates required field

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