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Form 79-770 is a backflow prevention assembly test and maintenance record for the City of Philadelphia. A city-certified technician completes it.
Section II is labeled test instrument calibration information. The printed lines are calibrated by, calibrated on, and next calibration due.
The repair note says all repairs and replacements must be completed within fourteen (14) days. That sentence is about the assembly repair, not a calibration interval for the gauge.
Completed forms go to PWD Industrial Waste and Backflow Compliance at 9001 State Road, Philadelphia, PA 19136.
THIS FORM (79-770) MUST BE COMPLETED BY A CITY CERTIFIED TECHNICIAN. II. TEST INSTRUMENT CALIBRATION INFORMATION. CALIBRATED BY. CALIBRATED ON. NEXT CALIBRATION DUE. ALL REPAIRS / REPLACEMENTS MUST BE COMPLETED WITHIN FOURTEEN (14) DAYS. SEND COMPLETED FORMS TO: PWD INDUSTRIAL WASTE & BACKFLOW COMPLIANCE, 9001 STATE ROAD, PHILADELPHIA, PA 19136.
Philadelphia Water Department form 79-770
| Line on the form | Words the form prints |
|---|---|
| Who completes it | A city certified technician |
| Section II | Test instrument calibration information |
| Calibration lines | Calibrated by, calibrated on, next calibration due |
| Repair note | Fourteen (14) days for repairs and replacements |
| Where the form goes | 9001 State Road, Philadelphia, PA 19136 |
What was not measured
What was not measured: form 79-770 does not state a fee, a turnaround, or a number of months for the next calibration due line.
Questions this page can answer
Section II is test instrument calibration information. The lines are calibrated by, calibrated on, and next calibration due.
No. The form says all repairs and replacements must be completed within fourteen (14) days. That line is the repair note.
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