31D-142 (5) Uepaitment of Public Works BACKFLOW PREVENTION DEVICE TEST STATUS inm41 [/
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125 Locust StreetSupplier Ahnu41 [ ]
Northampton,MA 0-1060 REPORT FORM SuppllerSemi4nnu41 [ ]
413-507-1570
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The Northampton Department of Public Works is responsible for scheduling the testing intervals.
Testing by the D.P.W. will be invoiced at the rate of$65.00 for a single backflow device and$35.00 per
device for multiple devices. Re-testing of failed devices will be invoiced at the same rate as normal
testing. In addition to the testing fees, an annual registration fee of$20.00 for each device will be
invoiced on or about the month of December for the following year.
If you have any questions concerning this matter, please contact the Department of Public Works at(413)
587-1570.
Very truly yours,
George Andrikidis, P.E.
Director of Public Works
CITY OF NORTHAMPTON; MASSACHUSETTS
DEPARTMENT OF PUBLIC WORKS
125 LOCUST STREET4
1 NORTHAMPTON, MA 01060
413-587-1570
FAX 413-587-1576
George Andrikidis, Y.E.
Director of Public If irks
2/18/2004
1s
Main Street LLP
C/O Colebrook Realty Services, Inc.
1441 Main Street j
Springfield, MA 01103 ..
Dear Customer:
This notice is to inform City of Northampton owners of backflow devices of their responsibilities and the
City's policy regarding both annual and semi-annual inspections and testing of these devices.
Pursuant of the State of Massachusetts,Department of Environmental Protection(Department)310
CMR 22.22 and the Northampton Department of Public Works(D.P.W.)Cross Connections
Regulations, the owners of cross connections have responsibilities in regards to testing and
backflow device maintenance. Listed below are these responsibilities:
1. Having suitable arrangements made, so that inspections can be made during regular business
hours.
2. Maintaining a spare parts kit and any special tools required for the removal and reassembly of
devices.
3. Providing necessary labor for inspection and testing by the D.P.W.
4. Having any device which fails a test or is found defective either overhauled, repaired or
replaced, and re-inspected within two weeks of the initial inspection date, pursuant to 310 CMR
22.22 (9)(f). A permit from the Northampton Plumbing Inspector may be necessary to
accomplish the above.
5. Maintaining on the premises complete records on all devices including as-built plans for the life
of the device, design data sheets, and copies of the Inspection and Maintenance Report Forms
for tests conducted by the water suppliers for seven years.
6. The supplier of water will test each reduced pressure backflow preventer and air gap separation
semi-annually. If the supply is used less than six months of the year,these devices shall be
inspected and tested by the supplier of water once each year. The supplier of water shall test
and inspect each double check valve assembly annually. Each test shall be conducted by a
Certified Backflow Prevention Device Tester and recorded on the DPW's Inspection and
Maintenance Report Form.