Jackson County Water and Sewerage Authority
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Backflow Forms

View and download all Backflow forms and documents by clicking the links below.

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Download Backflow Tester Letter

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Certified Prevention Device Tester Application

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Vault Access Waiver and Release of Liability

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Prevention Device Testers Code of Conduct

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Backflow Maintenance Test Form

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Cross Connection Control Program

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Backflow Testers List

Get in Touch!

Phone: (706) 367-1741
Fax: (706) 367-1759
Bill Payment: (855) 383-1792


Main Office and Customer Service
117 MLK Ave
Jefferson, GA 30549

Quick Links

  • Service Map
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  • Useful Links
  • Social Media Terms of Use Policy

View Documents & Forms

Click the following links to download various document viewers.

  • Acrobat Reader
  • MS Excel Viewer
  • MS Powerpoint Viewer
  • MS Word Viewer
  • Facebook
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