Irrigation Backflow Compliance Survey

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The City of Fort Lauderdale Public Works Department needs your help verifying irrigation backflow prevention assembly at your property.

For the health and safety of our drinking water, the installation and certification of a backflow prevention assembly is required for the dedicated irrigation service connection according to the State of Florida Administrative Code (Chapter 62-555.360) and City of Fort Lauderdale Municipal Code of Ordinances (Chapter 28-153, 28-155). Backflow prevention assemblies will prevent cross-connection events (back pressure, back siphonage) from occurring and creating a hazar to the municipal drinking water system.

Type of backflow (PVB, AVB, RPZ, other), make, model, and serial number if available, or select “No”, if there is currently no irrigation backflow prevention assembly at the property. Scroll to bottom of this page to view example pictures of the different types of Backflows.

Please correct the fields below:

Please correct the field(s) marked in red below:

1

Property address at Service Connection:

Property address at Service Connection:

Name

Street

Apt

City

State

Zip

2

Property “Account Number” (listed on the notice sent by the City)?

Property Account Number

3

Backflow Prevention Assembly

Backflow Prevention Assembly

Yes

No

4

If yes, date of last test:

Date

5

Type:

Type:

PVB

AVB

RPZ

Unknown

6

Upload a Photo of the Backflow device. (Optional)

Photo

Click button for uploading file

Clear

Maximum size allowed: 5 MB

Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

7

I’d like to request an inspection at the Property Address above.

Please Contact Me At:

To receive a copy of your submission, please fill out your email address below and submit.
Email Address

Page 1 / 1

If you prefer to mail or fax in your form click here. word

For general questions, or to schedule a courtesy inspection, please contact Environmental Inspector Malvis Campbell at 954-828-7728 or email backflow@fortlauderdale.gov.

Examples of AVBs (Air Vacuum Breakers):

AVB1 AVB2 AVB3 Backflow1 Backflow2 AVB6 AVB7

Examples of PVBs (Pressure Vacuum Breakers):

PVB1 PVB2

Examples of RPZs (Reduced Pressure Zone):

RPZ1

RPZ2