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2. Your form submission will be reviewed within 24 hours by CFPUA's Community Compliance Section. You will be contacted if any further info is needed. After the 24-hour review period, please contact Customer Service at 910-332-6550 or use the Customer Service link at right, select the “Backflow/Meter Set Process” and complete that form to initiate the process to have the meter set.
3. Customer Service
5. Project Address*
7. GENERAL OR UTILITY CONTRACTOR NAME*
8. Foreman:*
10. Address*
12. Phone Number*
13. Email*
15. PLUMBER OR FIRE SPRINKLER CONTRACTOR NAME*
16. License*
18. Address*
20. Phone Number*
21. Email*
23. Backflow Prevention Assembly Information:
25. Replace the existing backflow?*

    1. Yes
    2. No
26. Serial Number being replaced*
28. Manufacturer*
29. Model*
30. Size*
32. Serial Number*
33. Location Onsite*
35. Installation Type*

    1. Temporary
    2. Permanent
36. Inspection*

    1. Ready for Inspection
    2. Will call for Inspection
37. Type*

    1. Reduced Pressure (RP)
    2. Double Check (DC)
    3. Reduced Pressure Detector (RPDA)
    4. Double Check Detector (DCDA)
39. Type of commercial hazard or water use*

    1. Automotive
    2. Car Wash
    3. Commercial
    4. Construction
    5. 5 (or more) story building
    6. Fire Service

    1. Food Service
    2. Industrial
    3. Irrigation Meter
    4. Irrigation Subtraction Meter
    5. Laundry
    6. Medical/Institutional

    1. Mortuary
    2. Mutli-Family
    3. Pesticide
    4. Pool
    5. Waterfront
    6. Wastewater Treatment
40. Other use
42. Backflow Prevention Assembly Installation Guide

    • The backflow prevention assembly should be as close to the water meter or service connection as possible. In all cases it shall be before the first branch in the water service. Call for more information about isolation backflow assemblies.

    • The double check valve and reduced pressure assemblies shall be installed at least 12 inches above the finished grade, flood level, or floor.

    • The maximum installation height of a backflow prevention assembly is sixty inches. • An enclosure shall be provided that protects the assembly from theft, vandalism, tampering, weather, and freezing.

    • In the floor, underground, and vault installations are prohibited.

    • There shall be 12 inches clearance on all sides of the assembly.

    • Electrical equipment, outlets and breaker boxes shall not be located beneath the assembly. • Only in-line testable assemblies appro

    • The type of assembly shall be appropriate for the hazard as identified by the Community Compliance Office

    • Prior to installing assemblies it is recommended that the Community Compliance Office be contacted to verify that the type of assembly being used is appropriate for thehazards.

    • Installation, relocation, replacement, and removal of backflow prevention assemblies require a CFPUA permit and inspection and a separate New Hanover County plumbing permit and inspection. Water meters will not be set until the CFPUA has inspected and approved the backflow prevention assembly and its installation.

    • It is the responsibility of the installer to ensure that backflow prevention assemblies function properly and are tested by a certified tester within 15 days of the installation.

    • G.S. 143-155: Local government water systems and large community water systems shall require separate meters for new in-ground irrigation systems on lots platted and recorded in the office of the register of deeds in the county or counties in which the real property is located after July 1, 2009, that are connected to their systems. A backflow prevention assembly is required on irrigation services and shall be permitted separately from the construction water BFP.

44. Signature of Plumber/Contractor*
    By typing your name here you affirm you have read and will abide by CFPUA backflow prevention assembly installation guidelines.
45. Date
    Date
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field