Olin $25 Backflow Test
Request For Backflow Test Online Form
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NOTE: In order to use the file upload feature on this form you will nedd to have Adobe Flash Player installed on your computer!
General Information:
Billing Information:
Device Information:
City of Tampa Test Forms:
INSTRUCTIONS:
If you received a City of Tampa test form(s), please scan the form(s) you received and upload using the fields below. File formats permitted for upload are .jpg, .png or .pdf file formats and must not exceed 2 MB in size per file.
Hillsborough County Test Forms:
INSTRUCTIONS:
If you received a post card from Hillsborough County you will need to complete the Hillsborough County Backflow Test Form, click here to download the form. Once you have completed this form you will then need to save it to your computer as a PDF and upload it using the field below. This file must not exceed 2 MB in size.

IMPORTANT NOTE:
If you do not fill the form out and we have to there is an additional $15.00 per form.
Signature:
By typing your name below you authorize Olin Plumbing, Inc. to perform the backflow test at the address stated above.
NOTE: All invoices & a copy of the test report(s) will be e-mailed to you unless otherwise noted.