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Backflow Prevention Installation Safety Checklist

Free Safety Checklist template · Category: PlumbingView all Safety Checklist templates
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Risk Assessment Description:

This backflow prevention installation safety checklist template from Health & Safety Zone helps plumbers, heating engineers and Gas Safe registered professionals ensure safe and compliant installation of backflow prevention devices.

It covers all essential safety dimensions including risk assessment, competence, site conditions, installation integrity, testing, PPE and emergency arrangements. The checklist aligns with the Water Supply (Water Fittings) Regulations 1999, BS EN 806 and relevant HSE guidance.

Use this checklist for:

  • Pre‑installation checks – verify planning, competence and site readiness before work begins.
  • Installation verification – confirm the device is fitted, secured and tested correctly.
  • Post‑installation sign‑off – record results, ensure documentation and hand over to the client.

Each item is answered Yes, No or N/A – any No answer must be resolved before proceeding.

After installation, the device should be incorporated into a regular maintenance programme and the test records retained as part of the building’s water safety documentation.

Fully editable and shareable – customise the questions to your site, download as a PDF and share with your team.

The checklist should be completed on site by the appointed competent person, with each response recorded and any non‑conformities rectified before the water service is restored. It supports ongoing compliance with the Water Supply (Water Fittings) Regulations 1999 and provides evidence for building control inspections.

Compliant with: Water Supply (Water Fittings) Regulations 1999; BS EN 806; HSE guidance on water safety.

Sample PDF Document Image:

Checks covered in this Backflow Prevention Installation checklist

This Backflow Prevention Installation safety checklist template covers 23 checks. Customise the questions to your workplace, then download a professional, print-ready PDF with Yes / No / N/A tick-boxes and a comments space.

#Checklist item
1Has a risk assessment for the backflow prevention work been completed and communicated to all operatives?
2Is a method statement or installation procedure in place for the specific device being fitted?
3Is a permit to work for water service isolation issued where required?
4Are all operatives trained and competent in backflow prevention device installation and testing?
5Is the operative holding a valid Gas Safe registration where gas‑related work is involved?
6Is the water supply isolated and depressurised before commencing installation?
7Is the work area clear of slip, trip and other hazards and adequately ventilated?
8Is the selected backflow prevention device appropriate for the system pressure and intended use?
9Has the device been inspected for damage, correct labeling and certification prior to fitting?
10Is the backflow prevention device correctly labelled and its certification displayed as required by the Water Supply (Water Fittings) Regulations 1999?
11Are all pipework connections tightened to the manufacturer’s torque specifications?
12Is the device installed in the correct orientation as indicated by the manufacturer?
13Are all fittings and joints sealed using approved methods and materials?
14Is a test valve or isolation valve provided and installed for post‑installation testing?
15Has the device been pressure‑tested in accordance with BS EN 806 and recorded?
16Is the device’s test result within the acceptable tolerance limits?
17Are all safety devices such as pressure relief valves inspected and functional?
18Is the area around the installation free of debris and has the pipework been flushed to remove any contaminants before the water service is restored?
19After completion, is the water supply re‑pressurised and tested for correct operation and no leakage?
20Are appropriate PPE (gloves, eye protection, safety footwear) worn by all operatives?
21Are barriers or signage in place to warn of isolated water services during work?
22Are first‑aid provisions and emergency shut‑off points identified and accessible?
23Has the installation been signed off, documented and the records filed as required?

Frequently asked questions

Are these safety checklist templates really free to download?

Yes — completely free. Customise any checklist to your workplace and download a professional, print-ready PDF in minutes. No paywall — a free account is all you need to download.

What format do the safety checklists download in?

Checklists download as a professional PDF, ready to print and complete on-site — each question has clear Yes / No / N/A tick-boxes and a comments space. You choose portrait or landscape at download. Word and spreadsheet formats are being added.

Can I customise the checklist questions to my workplace?

Yes — fully. Add your own questions, edit or remove any of the pre-written ones, and reorder them to suit your site, task or inspection before you download.

Are the safety checklists suitable for UK workplaces?

Yes. The checklists are written around UK health and safety good practice and HSE guidance, and are suitable for inspections, audits, toolbox checks and routine workplace monitoring.

Do I need an account to use the checklist templates?

You can build and preview a checklist without an account. To download the PDF you'll need a free account — it takes less than a minute, costs nothing, and also lets you save checklists to your dashboard and edit them later.

Can I add my company logo and branding to the checklist?

Yes — add your company logo, colours and details on Standard and Pro plans, so the exported checklist carries your own branding. Guests and Free downloads carry Health & Safety Zone branding.

How do I complete the checklist once it is downloaded?

The exported checklist is a blank, ready-to-use document: print it and tick Yes, No or N/A against each question and write any comments in the notes space, then sign and date it in the sign-off section.

What types of safety checklist can I create?

We are building specialist checklists across a wide range of subjects and industries — fire safety, workplace inspections, equipment and machinery checks, site inductions, vehicle checks, PPE, first aid and more. Browse by category to find the right one.

How often should safety checklists be completed?

It depends on the activity and your risk assessment — many checks are daily, weekly or monthly, while others are done before each task or shift. Completed, dated checklists provide a useful record of your monitoring.

Are the checklists a substitute for a risk assessment?

No. A checklist is a monitoring and inspection tool that complements your risk assessments and method statements — it helps confirm that controls are in place and working. Use them alongside your risk assessments.

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