Backflow Test Report

All submitted Backflow Test Reports must be complete and legible and submitted to the Village by 12/31 of each year.

Forms are accepted by fax, but can be sent in by email, USPS, or dropped off in person.

Please mail to:
Village of Middlefield Water Department
14860 N State Avenue
Middlefield, Ohio 44062

Fax: 440.632.0591

You may also email reports to 


Backflow Regulations
Backflow Test Form – Blank

Backflow Prevention Guide

Find a Certified Tester

To find a certified tester for a backflow prevention device, click HERE


Backflow can be described as “a reversal of the normal direction of flow within a piping system” or as “the flow of water or other liquids, mixtures or substances into the distribution pipes of a potable water supply from any source other than the intended source of the potable water supply.”


The potential for a backflow condition occurring in a water system is all too likely in many of our homes, factories and public buildings. The existence of improper plumbing connections presents cross-connections that may, under backflow conditions, permit the water to flow the wrong way within the piping.


The probability of backflow taking place at any given outlet may actually be very small. But in view of a large number of service connections, the multiple cross-connections at each service connection and the potential for cross-connections to be created, then the probability becomes very significant and must be dealt with in a positive manner.