Backflow Prevention Program SURVEY
Search Our Site!
 
 

Name:

Address:

City: State: Zip:

 SBL:

Location:
                              (Street Address)
 

Please answer the questions below. If you have questions or need assistance please contact the Water Utility at 855-5080 between 8:00 a.m. and 3:00 p.m. Monday through Friday.

1. Do you have an underground lawn irrigation/sprinkler system? (see Page 2 - brochure)  Yes No
     If yes, what is the source? Water Utility   Lake   Well     Other  
     
2. Do you have an in-home fire sprinkler system?  Yes No
     
3. Do you have a frost-proof Yard Hydrant? (see Page 3 - brochure)  Yes No
     
4. Do you heat your home with a hot water heating system such as Solar of Geo Thermal? (see Page 3 - brochure)  Yes No
     If yes, what is the source?  Solar  Geo Thermal  Other  
     
5. Do you have a hot tub or Jacuzzi tub with a permanent submerged water fill pipe? (see Page 2 - brochure)  Yes No
     
6. Do you have a swimming pool with a permanent submerged water fill pipe? (see Page 2 - brochure)  Yes No
     
7. Do you have Vacuum Breaker Devices on all of your hose bibs? (see Page 4 - brochure)
If no, The Arkansas Plumbing Code requires that you install hose bib type vacuum breakers on all threaded faucets around your home. These devices are inexpensive and are available at local hardware or home improvement stores.		 Yes No
     
8. Do you have an existing Backflow Prevention Assembly (RPZ)? (see Page 2 - brochure)
If yes: You should contact the ACC (Architectural Control Committee 855-8080) and they will log the necessary information regarding the RPZ. The Bella Vista Water Utility will provide a free inspection of all existing RPZ installations to assure it meets ADH and State Plumbing Codes for compliance.		  Yes No


An annual inspection must be completed by a state certified Assembly Testing Technician
on all backflow devices and filed with the Water Utility

    

 

  New Page 2
 

Membership Services| Golf| Recreation| Lakes| Communications| Employment| Community Outreach
Maintenance & Water | Lot Auctions| Board/Administration| Calendar/Events| Restaurants| Privacy Policy| Home
Copyright © 1995-2009 Bella Vista Village Property Owners Association
Another DesignWorks Creation