Schedule a Test - Municipal Backflow

Schedule A Test

Please fill out the form below and we will contact you to set up a time for one of our Technicians to come and Test your Backflow Assembly. You may also contact us by phone to setup your test at (312) 638-9878.

CID #
Enter your CID# (Customer Identification Number) located at the top right corner of your letter.
CCN # or Hazard ID
Often provided by your City or Village.
Name:*
First Last
Commercial or Residential Property:*
Commercial
Residential
Company or Business Name:*
For Scheduling: Please provide your normal weekday Business Hours of Operation, so that one of our technicians can gain access to the property, to preform testing.
Opening Time:*

: HH

MM

Closing Time:*

: HH

MM

Residential Irrigation?*
Yes
No
Not Sure?
Device Location?*
Inside Residence
Outside Residence
Not Sure?
Please choose the earliest date that you or your Irrigation Company will have the Backflow installed and water turned on by.*
Date Format: MM slash DD slash YYYY

The best way to contact me by phone is:*
My Mobile #
Home #
Work / Business #
Phone:*
Address:*
Street Address Address Line 2 City State ZIP Code

Email:*

Comment or Question:*

Our Service Area

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MUNICIPAL BACKFLOW LLC

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OFFICE HOURS

MON - FRI 8 - 5

312-638-9878