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Region of DurhamBackflow Solutions2022-08-10T15:32:52-05:00

Region of Durham

This survey is for premise isolation only.

Results must be submitted within 90 days of notification by the Region of Durham.

Region of Durham, ON

Facility Information
Facility Name*
CCN Number*
Contact Name*
First Last
Address*
Street Address Address Line 2 City / Township State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Account Number
Owner Information
Same as facility information*
- Yes
- No
Contact Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Business Name
Phone*
Email*
Surveyor Information
Name of Certified Tester*
First Last
Tester Certification Number*
Phone*
Surveyor Email*
Business Name*
Business Address*
Street Address City State / Province / Region ZIP / Postal Code
General Survey Information
Survey Date*
MM slash DD slash YYYY
Type of Water Use*
Building Type*
Is there a fire protection system?*
- Yes
- No
Fire Service Connection
Location*
Meter Number
Hazard Level*
- Moderate
- High
Fire Device Status*
- Existing Device
- Device Needed to be Installed
Existing Fire Device Type*
Fire Device Serial Number*
Fire Device Size*
Fire Device Make*
Ames*
Apollo*
Conbraco*
Febco*
Watts*
Wilkins*
Other Make and Model*
Last passing test date
MM slash DD slash YYYY
Acceptable Protection in Place*
- Yes
- No
Surveyor Recommendations
Please provide suggested type/make/model/size or any corrective action needed.
Do you have a second fire connection?
- Yes
Second Fire Connection
Location*
Meter Number
Hazard Level*
- Moderate
- High
Second Fire Device Status*
- Existing Device
- Device Needed to be Installed
Existing Fire Device Type*
Fire Device Serial Number*
Fire Device Size*
Second Fire Device Make*
Ames*
Apollo*
Conbraco*
Febco*
Watts*
Wilkins*
Other Make and Model*
Last passing test date
MM slash DD slash YYYY
Acceptable Protection in Place*
- Yes
- No
Surveyor Recommendations
Please provide suggested type/make/model/size or any corrective action needed.
Is Premise Isolation required for this facility*
- Yes
- Yes, with Isolation Protection as an alternative due to restrictions that prevent true Premise Isolation
- No
Domestic/Irrigation Connections
Connection #1*
- Domestic Connection
- Irrigation Connection
Location*
Meter Number
Hazard Level*
- Moderate
- High
Device Status*
- Existing Device
- Device Needed to be Installed
Existing Device Type*
Device Serial Number*
Size*
Make*
Ames*
Apollo*
Conbraco*
Febco*
Watts*
Wilkins*
Other Make and Model*
Last passing test date
MM slash DD slash YYYY
Acceptable Protection in Place*
- Yes
- No
Surveyor Recommendations
Please provide suggested type/make/model/size or any corrective action needed.
Do you have a second connection?
- Yes
Connection #2
Connection #2*
- Domestic Connection
- Irrigation Connection
Location*
Meter Number
Hazard Level*
- Moderate
- High
2nd Device Status*
- Existing Device
- Device Needed to be Installed
Existing Device #2 Type*
Device Serial Number*
Size*
Device #2 Make*
Ames*
Apollo*
Conbraco*
Febco*
Watts*
Wilkins*
Other Make and Model*
Last passing test date
MM slash DD slash YYYY
Acceptable Protection in Place*
- Yes
- No
Surveyor Recommendations
Please provide suggested type/make/model/size or any corrective action needed.
Do you have a third connection?
- Yes
Connection #3
Connection #3*
- Domestic Connection
- Irrigation Connection
Location*
Meter Number
Hazard Level*
- Moderate
- High
3rd Device Status*
- Existing Device
- Device Needed to be Installed
Existing Device #3 Type*
Device Serial Number*
Size*
Device #3 Make*
Ames*
Apollo*
Conbraco*
Febco*
Watts*
Wilkins*
Other Make and Model*
Last passing test date
MM slash DD slash YYYY
Acceptable Protection in Place*
- Yes
- No
Surveyor Recommendations
Please provide suggested type/make/model/size or any corrective action needed.
Do you have a fourth connection?
- Yes
Connection #4
Connection #4*
- Domestic Connection
- Irrigation Connection
Location*
Meter Number
Hazard Level*
- Moderate
- High
4th Device Status*
- Existing Device
- Device Needed to be Installed
Existing Device #4 Type*
Device Serial Number*
Size*
Device #4 Make*
Ames*
Apollo*
Conbraco*
Febco*
Watts*
Wilkins*
Other Make and Model*
Last passing test date
MM slash DD slash YYYY
Acceptable Protection in Place*
- Yes
- No
Surveyor Recommendations
Please provide suggested type/make/model/size or any corrective action needed.
Do you have a fifth connection?
- Yes
Connection #5
Connection #5*
- Domestic Connection
- Irrigation Connection
Location*
Meter Number
Hazard Level*
- Moderate
- High
5th Device Status*
- Existing Device
- Device Needed to be Installed
Existing Device #5 Type*
Device Serial Number*
Size*
Device #5 Make*
Ames*
Apollo*
Conbraco*
Febco*
Watts*
Wilkins*
Other Make and Model*
Last passing test date
MM slash DD slash YYYY
Acceptable Protection in Place*
- Yes
- No
Surveyor Recommendations
Please provide suggested type/make/model/size or any corrective action needed.
Full Disclosure*
I agree
This form is intended to assist the Authorized Tester in carrying out a survey for Premise Isolation of potential cross connection situations. It is the responsibility of the owner or building occupier to bring to the attention of the Authorized Tester all water uses within the premises to permit inspection for potential cross connections and recommendation of corrective actions.
Owner/Tenant Signature*
Authorized Tester Signature*
The personal information collected herein is subject to the Municipal Freedom of Information and Protection of Privacy Act. The information is collected under the authority of the Region of Durham By-law 24-2018 and may be used for the enforcement and administration of the By-law and will be stored by the Region for such period of time which facilitates the enforcement and administration of the By-law. Completion of this form constitutes consent by the owner and Authorized Tester to these terms and uses, unless otherwise modified or revised in writing to the Commission of Works for the Region of Durham.
Untitled

Δ

Durham Region strongly recommends that you obtain several quotes before selecting a contractor and does not endorse or provide warranty of any services or prices. Please also be advised that contractors operate independently from Durham Region. We recommend you check their references, insurance, discuss costs and obtain a Workplace Safety and Insurance Board clearance certificate before proceeding with any work.

Contractors & Testers

A Marco Plumbing Ltd.Backflow Solutions2019-10-30T12:41:53-05:00

A Marco Plumbing Ltd.

Whitby | (905) 619-9700
info@marcoplumbing.ca

A-Pex Plumbing IncBackflow Solutions2020-04-24T12:30:33-05:00

A-Pex Plumbing Inc

Oshawa | (905) 550-6644
Apexplumbinginc07@gmail.com

A.J. Hicks ContractingBackflow Solutions2020-12-16T09:09:47-05:00

A.J. Hicks Contracting

Whitby, ON | (905) 925-3163
ahicksc554@rogers.com

A&A Plumbing & Mechanical ServicesBackflow Solutions2019-10-29T08:30:30-05:00

A&A Plumbing & Mechanical Services

Markham, Ontario | (416) 688-1315
david.aaplumbing@gmail.com

AC MechanicalBackflow Solutions2019-10-10T09:57:31-05:00

AC Mechanical

Oakville | (905) 829-1705
tabitha@acmechanical.ca

AinsworthBackflow Solutions2019-10-10T07:48:17-05:00

Ainsworth

Toronto | (416) 678-7282
craig.barker@ainsworth.com

Analysts of Pneumatic Systems Ltd.Backflow Solutions2021-01-22T11:06:40-05:00

Analysts of Pneumatic Systems Ltd.

Stouffville, ON | (647) 284-2800
fredperryaps@nexicom.net

Andrews plumbing Ltd Backflow Solutions2019-10-16T08:13:23-05:00

Andrews plumbing Ltd

Whitby | (905) 626-3667 |
a_plumbing@outlook.com

B. Jackson Plumbing Ltd.Backflow Solutions2019-10-10T07:47:23-05:00

B. Jackson Plumbing Ltd.

Toronto | (416) 321-2001
backflow@bjacksonplumbing.ca

Backflow ProBackflow Solutions2019-11-04T11:45:37-05:00

Backflow Pro

Brantford | 519-750-4244
backflowpro.ca

Backflow Specialties IncBackflow Solutions2019-10-10T07:50:12-05:00

Backflow Specialties Inc

Whitby | (905) 655-4772
Backflowcraig@hotmail.com

Ben Huston Plumbing & Piping LtdBackflow Solutions2019-10-10T07:50:37-05:00

Ben Huston Plumbing & Piping Ltd

Oshawa | (905) 579-8893
bhustplum@rogers.com

Bill Clarke Plumbing and HeatingBackflow Solutions2020-02-24T10:06:38-05:00

Bill Clarke Plumbing and Heating

Oshawa | 905-725-8563
Kim@clarkeplumbing.ca

Bradshaw Plumbing & Heating Inc.Backflow Solutions2019-10-10T07:51:20-05:00

Bradshaw Plumbing & Heating Inc.

Toronto | (416) 286-7511
bill@bradshawplumbing.com

Brent’s Plumbing Inc.Backflow Solutions2019-10-10T07:51:48-05:00

Brent’s Plumbing Inc.

Courtice | (905) 434-1825
info@brentsplumbinginc.ca

Brian Hayes Plumbing IncBackflow Solutions2019-10-10T07:52:24-05:00

Brian Hayes Plumbing Inc

Oshawa | (905) 576-3043
klynn@hayesplumbing.ca

Bruce Clark & Son Plumbing & Mechanical LtdBackflow Solutions2019-10-16T08:12:33-05:00

Bruce Clark & Son Plumbing & Mechanical Ltd

Stouffville | (416) 677-1591
julie.jamie@bellnet.ca

Caldwell PlumbingBackflow Solutions2019-10-18T07:05:51-05:00

Caldwell Plumbing

Pickering | (905) 239-3950
caldwell.plumbing@gmail.com

Caledon Creek Mechanical LimitedBackflow Solutions2019-12-10T08:48:45-05:00

Caledon Creek Mechanical Limited

Caledon Village | (519) 927-0190
caledoncreek@sympatico.ca

Call the Plumbing Doctor Inc.Backflow Solutions2019-10-10T07:54:09-05:00

Call the Plumbing Doctor Inc.

Oshawa | (905) 432-1625
office@calltheplumbingdoctor.com

Canadian Tech Air SystemsBackflow Solutions2019-10-10T07:54:36-05:00

Canadian Tech Air Systems

Scarborough | (416) 291-1296
tonyfahy@ctas.ca

Century Plumbing & HeatingBackflow Solutions2019-10-10T07:55:03-05:00

Century Plumbing & Heating

Toronto | (416) 485-4655
centuryplumbing@on.aibn.com

Chris Duff Electric & PlumbingBackflow Solutions2021-07-09T11:13:17-05:00

Chris Duff Electric & Plumbing

Blackstock | 905.986.0845

duffelectricandplumbing@gmail.com

Classic Fire Protection Inc.Backflow Solutions2019-10-10T07:56:35-05:00

Classic Fire Protection Inc.

Burlington | (416) 740-3000
kosborne@classicfire.com
lgiraldi@classicfire.com

Combined Air Mechanical ServicesBackflow Solutions2019-10-10T09:56:08-05:00

Combined Air Mechanical Services

Mississauga | (416) 891-4135
plumbingdispatch@combinedair.com

Cynergy Mechanical Ltd.Backflow Solutions2019-11-11T12:34:12-05:00

Cynergy Mechanical Ltd.

Etobicoke | (416) 749-2200
aamorim@cynergymechanical.ca

D & L General Contracting and Fire Protection Inc.Backflow Solutions2019-11-26T13:01:00-05:00

D & L General Contracting and Fire Protection Inc.

Pickering | (905) 239-3372
dknappc514@rogers.com

Dalcro Mechanical Contracting Ltd.Backflow Solutions2019-10-10T07:57:27-05:00

Dalcro Mechanical Contracting Ltd.

Mississauga | (905) 274-2657
info@dalcro.ca

Dalray Contracting Inc.Backflow Solutions2019-10-10T07:58:20-05:00

Dalray Contracting Inc.

Bowmanville | (905) 623-5280
dalrayinc@nexicom.net

Danmac Plumbing & Drain Service LtdBackflow Solutions2019-10-10T08:31:30-05:00

Danmac Plumbing & Drain Service Ltd

Toronto | (416) 237-9161
vivian@danmacplumbing.com

DC PlumbingBackflow Solutions2019-12-16T10:54:15-05:00

DC Plumbing

Cannington | (705) 341-1376
dcplumbingcannington@gmail.com

Doyle Plumbing, Heating & CoolingBackflow Solutions2019-12-05T13:17:38-05:00

Doyle Plumbing, Heating & Cooling

Fraserville | (705) 939-6008
customerservice@doyleplumbing.ca

Durham Pioneer Plumbing inc.Backflow Solutions2020-03-09T13:54:45-05:00

Durham Pioneer Plumbing inc.

Oshawa | (905) 240-2290
Bob.penny@durhampioneerplumbing.ca

E Vaillancourt Plumbing & Heating LtdBackflow Solutions2019-10-29T06:21:20-05:00

E Vaillancourt Plumbing & Heating Ltd

Oshawa | (905) 576-7055
vaillancourtplg@bellnet.ca

G.O. Tap PlusBackflow Solutions2020-03-04T13:07:14-05:00

G.O. Tap Plus

Mississauga | (416) 695-4377
info@gotapplus.com

GNC Plumbing and HeatingBackflow Solutions2020-01-08T10:26:39-05:00

GNC Plumbing and Heating

Pickering | (416) 892-6150
gncplumbing99@gmail.com

GPS Gabe’s Plumbing Services Inc.Backflow Solutions2021-01-20T12:36:30-05:00

GPS Gabe’s Plumbing Services Inc.

Pickering | (416) 678-2871
gabe@gabesplumbing.com

Inter-Global Mechanocal ServicesBackflow Solutions2019-10-10T08:51:59-05:00

Inter-Global Mechanocal Services

Concord | (416) 242-2532
interglobalbackflowservices@gmail.com

Joe’s MechanicalBackflow Solutions2019-10-16T12:43:48-05:00

Joe’s Mechanical

Markaham | (416) 843-0900
joekgp@hotmail.com

Lanos Plumbing Services IncBackflow Solutions2019-10-10T08:54:25-05:00

Lanos Plumbing Services Inc

Cannington | (705) 432-2755
lanosplg@gmail.com

LEaC Shield Ltd.Backflow Solutions2020-11-12T13:08:11-05:00

LEaC Shield Ltd.

London, ON | (855) 946-1783
adirc@leacshield.com

LPI Mechanical IncBackflow Solutions2019-10-10T08:56:21-05:00

LPI Mechanical Inc

Brampton | (905) 794-0755
chad@lpigroup.ca

Macintyre PlumbingBackflow Solutions2020-01-10T14:35:33-05:00

Macintyre Plumbing

Port Perry | 905-914-0911
macintyreplumbing@outlook.com

MainlineBackflow Solutions2019-10-16T07:32:00-05:00

Mainline

Concord | (905) 761-0073
colinj@mainlineplumbing.ca

McWatters Mechanical LimitedBackflow Solutions2019-10-10T08:57:18-05:00

McWatters Mechanical Limited

Aurora | (905) 727-2420
kevin@mcwattersmech.ca

MPH Molinnus Plumbing and Heating LtdBackflow Solutions2020-02-24T10:05:23-05:00

MPH Molinnus Plumbing and Heating Ltd

Pickering | (416) 712-5098
g.molinnus@rogers.com

Mutual MechanicalBackflow Solutions2019-10-10T08:58:32-05:00

Mutual Mechanical

Oshawa | (905) 579-6089
admin@mutualmechanical.net

Newmarch Technical SystemsBackflow Solutions2019-10-22T10:16:31-05:00

Newmarch Technical Systems

Stouffville | (905) 640-8031
wayne@newmarchtechsystems.com

Ocean Mechanical IncBackflow Solutions2019-10-10T09:00:05-05:00

Ocean Mechanical Inc

Concord | (647) 333-2879
rbaldassini@oceanmechanical.com

Concord | (905) 760-1343
maria@oceanmechanical.com

Peel Plumbing & Mechanical Inc.Backflow Solutions2019-10-10T09:02:45-05:00

Peel Plumbing & Mechanical Inc.

Etobicoke | (416) 744-4206
sbpeel@bellnet.ca

Plumbing Masters IncBackflow Solutions2021-02-26T10:02:59-05:00

Plumbing Masters Inc

Ajax | (905) 427-9260
plumbingmasters@sympatico.ca

Preferred Mechanical Inc.Backflow Solutions2019-10-16T07:34:00-05:00

Preferred Mechanical Inc.

Toronto | (416) 717-2387
preferredmechanical@rogers.com

Pro-Tek Mechanical IncBackflow Solutions2019-10-10T09:11:26-05:00

Pro-Tek Mechanical Inc

Ajax | (905) 683-8315
j.zarb@pro-tekmechanicalinc.com

ProActive Water Solutions IncBackflow Solutions2019-10-10T09:05:45-05:00

ProActive Water Solutions Inc

Vaughan | (416) 249-2837
info@proactivewatersolutions.com

Rapid Plumbing Inc.Backflow Solutions2022-05-24T13:38:10-05:00

Rapid Plumbing Inc.

(416) 246-1264 | Toronto

service@rapidplumbing.ca

Reab Plumbing and BackflowBackflow Solutions2019-10-18T10:57:11-05:00

Reab Plumbing and Backflow

Toronto | (416) 432-7695
egeetan@gmail.com,

Renmar ServicesBackflow Solutions2019-10-30T12:43:04-05:00

Renmar Services

Oshawa | (289) 314-9339
mark@renmar.ca

Royal Plumbing LtdBackflow Solutions2019-10-10T09:15:06-05:00

Royal Plumbing Ltd

Foxboro | (613) 849-3072
royalplbg@hotmail.com

Secure Water Systems A Division of Griffin Mechanical Inc.Backflow Solutions2021-01-27T10:28:19-05:00

Secure Water Systems A Division of Griffin Mechanical Inc.

Guelph, ON
(519) 827-9622 | sws@bellnet.ca

Silver PlumbingBackflow Solutions2021-01-25T10:48:43-05:00

Silver Plumbing

Thornton, ON | (416) 820-6062
plumbingsilver@gmail.com

SRA Fire Protection Inc. Backflow Solutions2022-01-12T10:33:10-05:00

SRA Fire Protection Inc.

Pickering | (905) 424-3881
Shane@srafire.com

The Plumbers Edge IncBackflow Solutions2019-10-10T09:17:29-05:00

The Plumbers Edge Inc

Oshawa | (905) 259-5988
plumbersedge.oshawa@hotmail.com

Toram Mechanical IncBackflow Solutions2019-10-10T09:22:56-05:00

Toram Mechanical Inc

Ajax | (905) 427-7111
amy@torampm.com

Unified Mechanical IncBackflow Solutions2019-10-10T09:24:12-05:00

Unified Mechanical Inc

Courtice | (289) 830-1425
Unifiedmechanical@live.ca

Van Horne PlumbingBackflow Solutions2019-10-16T07:29:04-05:00

Van Horne Plumbing

Goodwood | (416) 554-2213
nickbrienza@gmail.com

Wet Bandits PlumbingBackflow Solutions2019-11-05T10:44:08-05:00

Wet Bandits Plumbing

Ajax | (647) 330-1181
info@wetbandits.plumbing

YCE Mechanical ServicesBackflow Solutions2019-10-11T12:07:46-05:00

YCE Mechanical Services

Whitby | (905) 922-2919
ycemechservices@rogers.com

ZENMECH Plumbing & Heating LTD.Backflow Solutions2020-03-11T07:42:43-05:00

ZENMECH Plumbing & Heating LTD.

Courtice | 905-436-6338
derick@zenmech.ca

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