(1) A BAT shall complete a backflow preventer inspection and field test report as required in WAC 246-292-034 (3)(c).

(2) The completed backflow preventer inspection and field test report must contain facility and hazard information including:

(a) Facility name;

(b) Service address;

(c) Name and contact information of the facility owner or owner's representative; and

(d) Description of downstream hazards or premises, such as the categories identified in WAC 246-290-490, Table 9, if known to the BAT.

(3) The completed backflow preventer inspection and field test report must contain backflow prevention assembly or AVB information including:

(a) Description of physical location;

(b) Assembly type;

(c) Manufacturer;

(d) Model;

(e) Serial number, if applicable;

(f) Size;

(g) Whether or not the assembly or AVB met the approval requirements in WAC 246-290-490(5) at the time of inspection;

(h) Whether or not the installation is new, existing, or a replacement; and

(i) For a replacement installation, the serial number of the previously installed assembly or AVB, if known to the BAT.

(4) The completed backflow preventer inspection and field test report must contain installation information including whether or not the backflow prevention assembly or AVB is properly installed:

(a) In an orientation that meets the approval requirements of WAC 246-290-490 (6)(a);

(b) According to industry standards, as required in WAC 246-290-490(6); and

(c) So that the air gap under the relief valve of a reduced pressure backflow assembly meets the approved air gap requirements in chapter 246-290 WAC.

(5) The completed backflow preventer inspection and field test report must contain results of backflow prevention assembly inspections and field tests conducted according to the field test procedures that meet the requirements of WAC 246-290-490 (7)(d), including:

(a) Accurate field test kit readings for the initial field test;

(b) Accurate field test kit readings for the field test conducted after maintenance or repair, if applicable; and

(c) If the backflow prevention assembly passed or failed each field test.

(6) The completed backflow preventer inspection and field test report must contain backflow prevention assembly or AVB maintenance and repair information, if applicable and known to the BAT, including a:

(a) Description of maintenance performed;

(b) Description of repairs made; and

(c) List of materials or replacement parts used.

(7) The completed backflow preventer inspection and field test report must contain field test kit information for each field test conducted, including:

(a) Manufacturer;

(b) Model;

(c) Serial number; and

(d) Date of the most recent laboratory accuracy verification or laboratory calibration that meets the requirements of WAC 246-292-034(6).

(8) The completed backflow preventer inspection and field test report must contain results of air gap inspections including:

(a) Measurements of the supply pipe diameter;

(b) Measurements of the air gap separation; and

(c) Whether or not the air gap is an approved air gap at the time of inspection.

(9) The completed backflow preventer inspection and field test report must contain remarks, if applicable, including, but not limited to:

(a) A statement that the backflow prevention assembly or AVB does not meet the approval requirements in WAC 246-290-490(5);

(b) A list of all missing or defective backflow prevention assembly or AVB components, including shutoff valves and test cocks; and

(c) A description of any conditions that could adversely affect the performance of the backflow preventer.

(10) The completed backflow preventer inspection and field test report must contain information about the BAT who inspected, field tested, maintained, or repaired the backflow preventer, including the BAT's:

(a) Printed name;

(b) Company name;

(c) Phone number; and

(d) BAT certification number issued by the department.

(11) The completed backflow preventer inspection and field test report must contain the date of each inspection, field test, maintenance or repair, if applicable, performed by the BAT.

(12) The completed backflow preventer inspection and field test report must contain a statement certifying that the BAT:

(a) Personally inspected and field tested the backflow prevention assembly; or

(b) Personally inspected the air gap or AVB; and

(c) Used field test procedures that met the requirements of WAC 246-290-490 (7)(d); and

(d) Provided true, complete, and accurate information in the report.

(13) The completed backflow preventer inspection and field test report must contain the signature of the BAT who inspected, field tested, maintained, or repaired the backflow preventer. The signature must be in original, copy, facsimile, or electronic format.