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 NOTE Registrations for All Assemblies Except Those Located in Health Care Facilities along with All Test Reports Can Be Done Onl 2019

9927 Template 2019-2025 Form

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Understanding the 9927 Template

The 9927 template, often referred to as the Wisconsin SBD 9927 test form, is essential for documenting cross-connection control performance tests. This form is particularly relevant for businesses and facilities that need to comply with state regulations regarding water safety and contamination prevention. The form captures critical information about the testing process and results, ensuring compliance with local health and safety standards.

Steps to Complete the 9927 Template

Completing the 9927 template involves several key steps to ensure accuracy and compliance:

  1. Gather necessary information about the assembly being tested, including its location and type.
  2. Conduct the performance test according to the guidelines set forth by the Wisconsin Department of Natural Resources.
  3. Fill out the 9927 template with detailed results from the performance test, including any discrepancies noted during the testing process.
  4. Ensure that all required signatures are obtained from qualified personnel who conducted the test.
  5. Submit the completed form electronically or via mail to the appropriate regulatory body.

Legal Use of the 9927 Template

The 9927 template serves a legal purpose in documenting compliance with state regulations. When properly filled out and submitted, it can be used as evidence of adherence to cross-connection control standards. This form must be completed accurately to avoid potential legal issues, including fines or penalties for non-compliance. It is crucial to understand the legal implications of the information provided on the form.

Key Elements of the 9927 Template

Several key elements must be included in the 9927 template to ensure it meets regulatory requirements:

  • Test Date: The date when the performance test was conducted.
  • Location: The specific location of the assembly being tested.
  • Test Results: Detailed results from the performance test, including any failures.
  • Signatures: Signatures from the tester and any witnesses required by state regulations.

State-Specific Rules for the 9927 Template

Each state may have specific rules governing the use of the 9927 template. In Wisconsin, it is essential to follow the guidelines established by the Department of Natural Resources. These rules dictate how the form should be completed, submitted, and retained. Familiarity with these regulations is vital for ensuring compliance and avoiding penalties.

Examples of Using the 9927 Template

Practical examples of using the 9927 template can help clarify its application:

  • A commercial building undergoing a cross-connection control performance test must complete the 9927 template to document the results for regulatory review.
  • A residential facility may use the form to demonstrate compliance with local water safety regulations after testing backflow prevention assemblies.

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