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Gold Plan Subscription Application

TVWD offers its Gold Plan subscription based annual backflow testing program for residential customers only. A $40 fee will be assessed, once annually, per backflow assembly, to the water bill associated with the service address. Only the customer named on the billing account for the service address may enroll in the Gold Plan.

Assemblies located inside the home or garage, in crawl spaces, behind locked gates, or homes with any other possible impediment (including animals in the yard) are not eligible for the Gold Plan. For customers with multiple backflow assemblies, each assembly will be tested under the Gold Plan (with a charge of $40 per assembly), as the Gold Plan is applied to all assemblies on the account.

Applications submitted after May 31st will be enrolled for the following year's testing season. Customers will be responsible for scheduling their own backflow test for the current year.

Customers will receive an email response to their application, either confirming enrollment in the Gold Plan program, or explaining why the account is not eligible.

Customer Information
NOTE: Only the customer named on the water bill may apply.
Address where water service is being provided. Please enter complete address.
Backflow Assembly Information
NOTE: Assemblies located inside garages or crawl spaces, or behind locked gates/fences, are not eligible.
Acknowledgement
I certify the information I have provided is true and correct. I grant Tualatin Valley Water District permission to schedule and authorize a certified backflow tester to enter the property listed above to test the backflow prevention assembly to assure program requirements have been met. By clicking on the acknowledgement button, I choose to voluntarily enter into this TVWD backflow assembly testing program which I understand will include a $40 fee (per assembly) to be added to my water bill. I also understand that if the repair cost of my assembly exceeds $50 it is my responsibility to pay for any additional repairs when repaired by a TVWD contractor. I understand the terms of this agreement will continue until I contact TVWD to remove myself from the program or when I discontinue service at the address listed. TVWD has the right to remove me from the testing program at their discretion. My name is listed on the account for the water service at this address.
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