Water Usage Reporting: Fire Main Pre-Flush and Bag Testing Water Usage Reporting: Fire Main Pre-Flush and Bag Test Date: * Contractor Name: * Contact Name: * Contact Phone: * Contact Email: * Name of Development / Building: * Address of Pre-Flush and Bag Test: * Address of Pre-Flush and Bag Test: Address of Pre-Flush and Bag Test: Address of Pre-Flush and Bag Test: City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Building Permit Number: * Date of Pre-Flush: * Water Volume Used for Pre-Flush (Gallons): * Date of Bag Test: * Water Volume Used for Bag Test (Gallons): * Comments: If you are human, leave this field blank. Submit Δ
