CRED Auto Draft f04f17a3049ccc7c571a05941ff19f01 – Backflow Prevention Services, LLC

799 Gardere Lane

Baton Rouge, LA 70817

4350 Poche Ct W

New Orleans, LA 70129

Call us:

(225) 763-6960 or (504) 582-9028

Site Use

qweqwe

Survey Date

Domestic Service Line

Fire Service Line

Irrigation Service Line

Service Line Material

Lead

Service Line Material

Service Line Material

Location ID

qweqwe

Location ID

Location ID

BP Present

qweqwe

BP Present

Irrigation BP Present

Correct Type

qweqwe

Correct Type

Correct Type

Manufacturer

qweqwe

Manufacturer

Manufacturer

Date Last Tested

qweqwe

Date Last Tested

Date Last Tested

Serial No.

qweqwe

Serial No.

Serial No.

Type BP Required

qweqwe

Type BP Required

Type BP Required