Online Service Request

Our online service request allows you to schedule your backflow test. Please fill out the form below to receive a return email with the projected date of your test.
You can also call us directly at 541.390.8990.

Name*
First Last
Company
Address*
Street Address City ZIP / Postal Code
Phone*
Email*
Water District
Name and Address to be Tested (If Different)
Location of Backflow Assembly*
Additional Comments
Test Needed*
- Standard Residential Double Check Backflow Test Up to 2" - $75
Total
$0.00

Credit Card*

Cardholder Name

Card Details