# SA Backflow Report (/docs/form-guides/plumbing/sa/sa-backflow-prevention-device-report)



The **SA Backflow Prevention Device Report** is used to record commissioning, annual testing, replacement, or decommissioning of backflow prevention devices in South Australia.

## Before you start [#before-you-start]

Have these ready:

* Test type and file (e)number
* Device make, model, serial number, and size
* Exact device location
* Site owner contact details
* Site occupier details if different from the owner
* Test kit number and calibration date
* Tester name, licence, phone, and signature
* Valve readings for the nominated device type

[The Office of the Technical Regulator says](https://www.energymining.sa.gov.au/industry/regulatory-services/office-of-the-technical-regulator/plumbing-trades) the completed report must be forwarded within **7 days** of completing the work.

<span id="after-export" />

## After download [#after-download]

Preview the PDF, download it, then email it to &#x2A;*[otr.plumbbackflow@sa.gov.au](mailto:otr.plumbbackflow@sa.gov.au)** or post it to:

Office of the Technical Regulator, Plumbing trades, GPO Box 320, Adelaide SA 5001.

<Callout type="warn" className="docs-callout-warn my-4">
  Tradie Forms prepares the PDF. It does not lodge the report with OTR or decide whether a device passes the test.
</Callout>

<span id="testDetails" />

## Test Details [#test-details]

Record why you are on site and the device identity.

### What to enter [#what-to-enter]

* Test type: commissioning, annual test, replacement, or removal/decommission
* Serial number of valve removed when replacing a device
* File (e)number and account number
* Device make, model, serial number, size, and type

### Tips [#tips]

Pick the device type that matches the installed hardware. The test results section only shows fields for RPZ, SCV/DCV, PTVB, or break tank devices.

### Before download [#before-download]

Check the test type and device details against the device tag and your test records.

<span id="deviceLocation" />

## Device Location [#device-location]

Record where the device is and who owns or occupies the site.

### What to enter [#what-to-enter-1]

* Exact device location (GPS coordinates or a clear description)
* Site owner name, business name, address, and phone
* Site occupier details if different from the owner

### Tips [#tips-1]

Use address search on Solo or Team for SA site owner addresses, then check suburb and postcode before download.

### Before download [#before-download-1]

Confirm owner and occupier details against the job booking or property records.

<span id="certification" />

## Certification [#certification]

Record test kit calibration and tester certification.

### What to enter [#what-to-enter-2]

* Test kit number
* Certification date of calibration
* Contractor business name or stamp
* Tester name, licence number, and phone
* Tester's signature and signed date

### Tips [#tips-2]

Enter the calibration date shown on the test kit record. Check that the kit and calibration meet the current OTR and testing requirements. Save tester details from the certification toolbar for repeat tests.

### Before download [#before-download-2]

Check calibration date, licence number, signature, and signed date before you download.

<span id="testResults" />

## Test Results [#test-results]

Record valve readings and pass checks for RPZ, SCV/DCV, or PTVB devices.

### What to enter [#what-to-enter-3]

* RPZ: downstream isolation valve, differential pressure, relief valve opening pressure, and check valve 2
* SCV/DCV: downstream gate valve and check valves 1 and 2
* PTVB: downstream gate valve, air inlet status, opened-at pressure if applicable, and check valve

### Tips [#tips-3]

Only fill the row that matches the device type you selected in Test Details. Leave other device result fields blank.

### Before download [#before-download-3]

Check readings against your test kit display and tick only the pass boxes that apply.

<span id="breakTank" />

## Break Tank [#break-tank]

Record registered break tank and air gap measurements.

### What to enter [#what-to-enter-4]

* Inlet orifice size or water service pipe size
* Minimum air gap, total head, break tank capacity, and overflow pipe size

### Tips [#tips-4]

This section appears when the device type is break tank and air gap. Pick whether you are recording inlet orifice size or water service pipe size before entering the measurement.

### Before download [#before-download-4]

Check units match the PDF: millimetres for sizes and head, litres for tank capacity.

<Card title="Open the SA Backflow Report" icon="hugeicons:play" href="/forms/sa-backflow-prevention-device-report">
  Prepare the backflow prevention device report.
</Card>