CHARLOTTE-MECKLENBURG UTILITIES BACKFLOW PREVENTION BULLETIN SUBJECT: Completing the Backflow Prevention Service Application (BSA) DATE: June 11, 1999 Charlotte-Mecklenburg Utilities (CMUD) requires that a completed Backflow Prevention Service Application (BSA) be provided for all CMUD-required backflow preventer installations. Projects involving plan review require the BSA as one of the documents to be submitted with plans to Mecklenburg County Engineering & Building Standards Department. Plans can not be approved for permitting without the required BSA. When completing the BSA, it is recommended, and often necessary, to get more information from others involved in the project, such as the plumbing/mechanical designer, the fire sprinkler system designer, the architect, the owner, and even the occupant. Complete accurate information is vitally important. Often, it is an Aoperations@ person within the occupant company=s organization that has the most complete knowledge of equipment that is or will be connected to the water system(s) and other water-use activities. Usually, information on the fire, domestic, and irrigation systems for a site can all be provided using the different sections of a single BSA form. However, if more than one of the same type service is involved for one address (for example, two domestic meters), please submit a separate BSA for the second service. Before submitting the BSA, please make sure that all “yes/no” questions are answered for each water service affected by the BP installation(s) and that all other requested information is provided. If the contractor responsible for the work is not known, please indicate so, e.g. “not known at this time.” The box in the lower right-hand corner of the sheet is “For CMUD Use Only;” please leave it blank. Signature of the responsible individual is required. Note that the backflow prevention requirement is subject to change if the information provided in the BSA is found to be inaccurate or if water-use activities change. Thank-you for your cooperation. If you have any questions about this matter, please call Bob Briggs at (704) 336-2997. Charlotte-Mecklenburg Utilities System Protection Division at 5100 Brookshire Boulevard, Charlotte, NC 28216 704/399-2221