Testing Agreement

Mount Pleasant Waterworks provides annually testing services for any customers with a Backflow Prevention Device. Federal and State regulations require that all Backflow Prevention Devices are tested annual.

Owner's Name:

Customer's Phone Number:

Customer's Email Address:

Customer's Account Number:

Mailing Address:

Service Address:

Type of Service:

Terms and Conditions

I understand that MPW will provide routine annual testing of the backflow prevention device referenced above.
I understand that MPW will notify me in writing of the date the backflow prevention device was tested and provide a copy of the test report.
I agree to pay the current approved rate per device for the annual test, which will be included on the water bill.
I understand that fees are subject to adjustment upon adoption of MPW's Annual Budget.
I UNDERSTAND THAT SHOULD MY BACKFLOW PREVENTION DEVICE FAIL THE ANNUAL TEST, THAT MPW WILL NOTIFY ME OF WHAT REPAIRS ARE NECESSARY AND I AM REQUIRED TO HAVE THE DEVICE REPAIRED WITHIN 30 DAYS
I understand, that I, the owner, shall hold MPW representatives harmless from and against all liabilities, damages, losses, etc., associated with testing the backflow prevention device.
I understand that this agreement may be canceled by MPW or me, the Owner, upon receipt of thirty days written notice; otherwise this Agreement will renew annually.

I, , understand by submitting this electronic form that I have agreed to the terms and conditions listed and have entered into a Backflow Testing Agreement with Mount Pleasant Waterworks, which will be automatically renewed annually.