Information about the tester:

• tester’s name

• tester’s contact details including address, telephone number and email address

• tester’s signature (water undertakers may accept electronic signatures)

• tester’s scheme name and membership number

Information about premises at which the RPZ valve is located:

• the address

• telephone number

• name and email address of the person responsible for the RPZ

Information about the installation including:

• the location of the RPZ valve on site

• a description of the water system which the RPZ valve forms part of including details of the type of equipment downstream of the RPZ valve.

• confirmation that consent to install has been granted

• confirmation that RPZ valve is installed in accordance with the conditions of consent

• date of installation/commissioning

• date of last test

Details relating to the RPZ valve including:

• the name of the manufacturer

• the model

• the size

• the serial number

Details relating to the testing including:

• test due date

• date of test

• test results, including in the case of a test failure details of any observations made and action taken.

• reason for test

Information about the test equipment used including:

• the make of test kit o test kit serial number

• calibration certificate

• confirmation of its suitability for system being tested (e.g. hot water)

For further details contact the local water undertaker.