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(225) 763-6960 or (833) 744-6620
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Consulting
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Training Overview
Backflow Boot Camp
Resources
Articles
The Power of Education in Mitigating Risk: A Case Study in Protecting Water Quality
Backflow Prevention Programs: Keys to Success
Are We Contaminating Our Water?
Backflow Prevention Programs: How Do I Get Started?
Drinking Water Safety (Part 1)
Drinking Water Safety (Part 2)
Drinking Water Safety (Part 3)
Videos
Pay For Other Services
Our Team
FAQ
Testing
Contact us
LUS
LUS Air Gap Response Form
LUS Approved Plumbers and General Testers
Home
Consulting
Courses & Training
Training Overview
Backflow Boot Camp
Resources
Articles
The Power of Education in Mitigating Risk: A Case Study in Protecting Water Quality
Backflow Prevention Programs: Keys to Success
Are We Contaminating Our Water?
Backflow Prevention Programs: How Do I Get Started?
Drinking Water Safety (Part 1)
Drinking Water Safety (Part 2)
Drinking Water Safety (Part 3)
Videos
Pay For Other Services
Our Team
FAQ
Testing
Contact us
LUS
LUS Air Gap Response Form
LUS Approved Plumbers and General Testers
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Air Gap Response Form
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Enter Hazard ID Number
*
Enter Account Number
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Choose one:
*
I will use the air gap method when filling my pool, hot tub, pond, fountain, or other vessel.
I intend to have an RP backflow preventer installed at my personal cost.
Confirm the following:
*
I agree to maintain an air gap, according to LDH regulations, when filling my pool, hot tub, pond, fountain, or other vessel.
Confirm the following:
*
I understand that an RP backflow preventer will be required should I not comply with these filling requirements.
Confirm the following:
*
I agree that upon installation, I will notify LUS or their authorized contractor of the make, model, serial number, and initial test report of the RP backflow preventer.
Confirm the following:
*
I agree that I will have the RP inspected and tested annually by an approved WSPS certified plumber or general tester, according to LDH regulations, and will submit the test report to LUS or their authorized contractor.
By typing my name, I certify that I am authorized to agree to the above terms and conditions.
*
Date
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Submission Confirmation
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Backflow Prevention Services, LLC