Backflow Prevention Forms and Permits

Forms for Property Owners

1. Information Request Form

Registers the property into the Backflow Prevention Program and helps the City understand and assess the risk level of a property, summarizes the main business activities, and identifies a primary contact.

Once an "Information Request Form Requirement" notice is received​, the Information Request Form must be completed and submitted by the property owner within 30 days of the date identified on the notice.

• Commercial Property Information Request Form (PDF)
• Residential Property Information Request Form (PDF)

2. Cross Connection Control Survey Report

This is a visual inspection of the property to identify all existing or potential cross connections between potable and non-potable water within the plumbing system. This will help staff determine the correct type of backflow preventer that is required to protect the City's water system.

Once a "Cross Connection Control Survey Requirement" notice is received, the Cross Connection Control Survey must be completed within 30 days and submitted by the property owner within 14 days of the survey being completed.

• Cross Connection Control Survey Report (PDF)
• Cross Connection Control Survey Report - Additional Page (PDF) (if applicable)
• Cross Connection Control Survey Report – Notes Page (PDF) (if applicable)

3. Backflow Preventer Test and Inspection Report

This must be completed by a Qualified Company when administering tests and repairs on new and existing backflow preventers.

This test and inspection report must be provided to the City within 14 days of the field test being conducted.

• Backflow Preventer Test and Inspection Report (PDF)
• New Watermain & Hydrant Backflow Test and Inspection Report (PDF)

4. Device Upgrade Implementation Report

To be used when the property owner undertakes corrective actions to remedy the deficiencies identified either on the Cross Connection Control Survey Report or the Backflow Preventer Test and Inspection Report.

The Backflow Preventer Replacement Form must be provided to the City within 14 days of implementing any corrective action.

• Backflow Preventer Replacement Form (PDF)

Standard Drawings

1. W106 - Meter & DCVA Backflow Preventer in Chamber (PDF)
2. W107 - Meter & DCVA Backflow Preventer in Chamber for Copper Services (PDF)
3. W109 - Industrial / Commercial Meter with Backflow Preventer & Valve Installation (Meter Room) (PDF)
4. W111 - 100mm - 300mm DCVA Backflow Preventer in Chamber (Fire Service Connection) (PDF)
5. W113 - Watermain Bypass Setup with RP Backflow Preventer (PDF)
6. W114 - Fire Hydrant with Meter and RP Backflow Preventer (PDF)

Building Permit Information

In accordance with the Building Code Act, a building (plumbing) permit from the City of Vaughan Building Standards Department must be obtained before any plumbing modifications are done under the Backflow Prevention Program.

Building Permit submissions are now accessible via our Online Permitting Portal found below

Vaughan Online Permitting Portal

For more information please view our Online User Manual Guide (PDF)

Should you require assistance, please contact a Citizen Service Representative at 905-832-8510 or buildingstandards@vaughan.ca. Office hours are ​Monday to Friday, 8:30 a.m. to 4:30 p.m., except public holidays.

When a domestic backflow prevention assembly is to be installed, please follow the application requirements below:

Forms, and Documents for all domestic backflow devices:

• Building Permit Requirements & Permit Portal Information (PDF)
• Application to Construct or Demolish Form (PDF)
• Backflow Preventer Installation Requirement Notice (PDF) issued by Environmental Services department - Backflow Prevention Program
• Commitment to General Review by Architect and Engineers (PDF) (if applicable)
• Commonly Used Applicable Laws Form (PDF)
• Non-Residential Plumbing Data Form (PDF)
• Owner's Letter of Undertaking (PDF)

Plans and specifications required for domestic devices up to 50 millimeter (two inches) pipe connection at the meter:

• Metro Area Plumbing Advisory Committee (MAPAC) applicable drawings (below)
  1. MAPAC 006 - Premise Isolation with Thermal Expansion for Water Services up to 1-inch Diameter (PDF)
  2. MAPAC 007 - Premise Isolation with Suspended Thermal Expansion Tank (PDF)
  3. MAPAC 008 - Premise Isolation with Floor Mounted Thermal Expansion Tank (PDF)
  4. MAPAC 009 - Premise Isolation, Suspended Thermal Expansion Tank and Dual Hot Water Supply (PDF)

or

• signed, dated and sealed professional engineer plans and specification

Plans and specifications required for domestic devices exceeding 50 millimeter (two inches) pipe connection at the meter:

• Signed, dated and sealed professional engineer plans and specifications

Inspections

Do not cover, conceal or otherwise restrict access to any plumbing until a building permit has been issued and a final plumbing inspection has been completed and passed by the City of Vaughan Building Standards Department.

To book a final plumbing inspection, contact Inspection Services at buildinginspections@vaughan.ca or 905-832-8511 from Monday to Friday 8:30 a.m. to 4:30 p.m., except public holidays.