1,372 WATER SYSTEMS · CODE MI

How to submit backflow test reports in Michigan

STATE FORM REQUIREMENTMI-EGLE

Michigan requires the Michigan EGLE Appendix D sample test form — BackflowGo fills the official PDF for you.

Michigan does not mandate a statewide official test form. This is the EGLE Cross Connection Rules Manual Appendix D sample record-keeping form — confirm the purveyor will accept it.

Acme Township - Hope VillageE-FILE READY Ada TownshipE-FILE READY Adams TownshipCONFIRM CHANNEL AddisonE-FILE READY AdrianE-FILE READY Adventure AcresE-FILE READY AhmeekCONFIRM CHANNEL AkronE-FILE READY Akron TownshipCONFIRM CHANNEL Alabaster TownshipE-FILE READY Alamo Cove Nursing HomeE-FILE READY Alan's Park - DurandCONFIRM CHANNEL Alan's Park - FowlervilleCONFIRM CHANNEL Alanson Estates Mobile Home ParkCONFIRM CHANNEL Albee TownshipE-FILE READY AlbionE-FILE READY Algoma EstatesCONFIRM CHANNEL Algonac, City ofE-FILE READY AlleganE-FILE READY Allegan County Services CenterE-FILE READY Allegan Mobile EstatesCONFIRM CHANNEL Allen ParkE-FILE READY Allendale TownshipE-FILE READY Alma, City ofE-FILE READY Almont, Village ofE-FILE READY Alpena, City ofE-FILE READY AlphaCONFIRM CHANNEL Alto MeadowsE-FILE READY Amber Estates Mobile Home ParkE-FILE READY Andelina FarmsE-FILE READY Andrews EstatesCONFIRM CHANNEL Andrews UniversityE-FILE READY Ann ArborE-FILE READY Ann Arbor TownshipE-FILE READY Apple Carr VillageCONFIRM CHANNEL Apple Grove EstatesE-FILE READY ApplewoodCONFIRM CHANNEL Arbor Ridge CondominiumsCONFIRM CHANNEL Arbor ViewE-FILE READY Arbor VillageCONFIRM CHANNEL Argentine Care CenterCONFIRM CHANNEL Arlington WoodsE-FILE READY Armada, Village ofCONFIRM CHANNEL Artesian Springs RV ResortCONFIRM CHANNEL Ash TownshipCONFIRM CHANNEL Ashley, Village ofE-FILE READY AthensE-FILE READY Au Gres TownshipCONFIRM CHANNEL Au Gres, City ofE-FILE READY Au Sable TownshipCONFIRM CHANNEL AuburnE-FILE READY Auburn HillsE-FILE READY AugustaE-FILE READY Augusta TownshipE-FILE READY Ausable Valley CommunityE-FILE READY Austin Commons IIE-FILE READY Autumn HillsCONFIRM CHANNEL Avra EstatesCONFIRM CHANNEL Bad AxeE-FILE READY Bair Lake Bible CampE-FILE READY Baldwin TownshipE-FILE READY Baldwin, Village ofE-FILE READY Baltimore TerraceE-FILE READY Bancroft, Village ofCONFIRM CHANNEL BangorE-FILE READY Bangor TownshipCONFIRM CHANNEL Bangor-Monitor Metro DistrictCONFIRM CHANNEL BaragaE-FILE READY Barn Swallow ApartmentsCONFIRM CHANNEL BarodaE-FILE READY Barron Lake/rosebushCONFIRM CHANNEL Barry TownshipE-FILE READY Barry's ResortCONFIRM CHANNEL Barton HillsCONFIRM CHANNEL Baseline Mobile Home ParkCONFIRM CHANNEL Bates TownshipCONFIRM CHANNEL Battle Creek - Verona SystemE-FILE READY Bavarian Softwater VillageCONFIRM CHANNEL Bay Area Water SystemE-FILE READY Bay City, City ofE-FILE READY Bay Co. Dept of Water & SewerE-FILE READY Bay Harbor ClubCONFIRM CHANNEL Bay Shore EstatesCONFIRM CHANNEL Bay View AssociationE-FILE READY Bayside (dba Continental Mhp)CONFIRM CHANNEL Beach House ApartmentsCONFIRM CHANNEL Beacon Home at ColbyE-FILE READY Bean Creek ResortCONFIRM CHANNEL Bear Creek Estates CondominiumE-FILE READY Bear Creek VillaE-FILE READY Bear Lake, Village ofE-FILE READY Beaver Creek ResortE-FILE READY Beaver Creek-Grayling Townships UaCONFIRM CHANNEL Beaver Road Area Water Assoc.CONFIRM CHANNEL Beaver TownshipCONFIRM CHANNEL BeavertonE-FILE READY Bedford HillsE-FILE READY Bedford MeadowsE-FILE READY Beecher Metropolitan DistrictE-FILE READY Beechwood Hills - Timber RidgeE-FILE READY BeldingE-FILE READY Bellaire, Village ofCONFIRM CHANNEL BellevilleE-FILE READY Bellevue Mobile Home ParkE-FILE READY Bellevue, Village ofCONFIRM CHANNEL Benton Charter TownshipE-FILE READY Benton HarborE-FILE READY Benzonia Village ofCONFIRM CHANNEL Bergland TownshipE-FILE READY BerkleyE-FILE READY Berlin TownshipE-FILE READY Berrien SpringsE-FILE READY BessemerE-FILE READY Bessemer TownshipCONFIRM CHANNEL Beulah, Village ofCONFIRM CHANNEL Beverly HillsE-FILE READY Big Creek/mentor Utility AuthorityCONFIRM CHANNEL Big RapidsE-FILE READY Bingham FarmsCONFIRM CHANNEL Bingham TownshipE-FILE READY Birch Run TownshipE-FILE READY Birch Run, Village ofE-FILE READY Birchwood EstatesCONFIRM CHANNEL Birchwood FarmsE-FILE READY BirminghamE-FILE READY Bishop Lake ApartmentsCONFIRM CHANNEL Black Bear FarmsE-FILE READY Blackman TownshipE-FILE READY Blair TownshipE-FILE READY BlissfieldCONFIRM CHANNEL Bloomfield HillsCONFIRM CHANNEL Bloomfield TownshipE-FILE READY Blue Lake ResidencesE-FILE READY Blue Spruce ApartmentsCONFIRM CHANNEL Blue Water Village Well Site, LLCE-FILE READY Blumfield-Reese Water Auth.E-FILE READY Boynaire Landowners AssociationCONFIRM CHANNEL Boyne City, City ofE-FILE READY Boyne Falls, Village ofCONFIRM CHANNEL Boyne Mountain ResortE-FILE READY Breckenridge, Village ofE-FILE READY Breitung Twp.-East KingsfordCONFIRM CHANNEL Briarcliff Homeowners AssnE-FILE READY Bridgeport TownshipE-FILE READY BridgmanE-FILE READY Brighton, City ofE-FILE READY Briley TownshipE-FILE READY BrittonCONFIRM CHANNEL BronsonE-FILE READY Brook of Houghton LakeE-FILE READY Brookdale AdrianE-FILE READY BrooklynCONFIRM CHANNEL Broomfield ValleyCONFIRM CHANNEL Brown CityE-FILE READY Brownstown TownshipE-FILE READY Bruce TownshipE-FILE READY BuchananE-FILE READY Buckley, Village ofCONFIRM CHANNEL Buel Hill Estates (dba Eagles Landing)CONFIRM CHANNEL Buena Vista EstatesE-FILE READY Buena Vista TownshipCONFIRM CHANNEL Burr OakCONFIRM CHANNEL Burt TownshipCONFIRM CHANNEL Burt View AssociationCONFIRM CHANNEL Burtchville TownshipCONFIRM CHANNEL Burton, City ofE-FILE READY Buttercup ShoresCONFIRM CHANNEL Butterfield Woods SubdivisionE-FILE READY Byram RidgeCONFIRM CHANNEL Byron-Gaines Utility AuthorityCONFIRM CHANNEL Byron, Village ofE-FILE READY C & M Mobile Home CourtCONFIRM CHANNEL Cadgewith FarmsE-FILE READY Cadillac, City ofE-FILE READY Caledonia EstatesCONFIRM CHANNEL Caledonia TownshipE-FILE READY CalumetCONFIRM CHANNEL Calumet TownshipCONFIRM CHANNEL Cambridge VillageCONFIRM CHANNEL CamdenCONFIRM CHANNEL Camp Arcadia / LcaE-FILE READY Canterbury Estates MHPCONFIRM CHANNEL Canton TownshipE-FILE READY Capac, Village ofCONFIRM CHANNEL Capital CrossingsCONFIRM CHANNEL Carney-Nadeau Water & Sewer AuthorityCONFIRM CHANNEL Caro Riverview MHP LLCCONFIRM CHANNEL Caro, City ofE-FILE READY Carrollton TownshipE-FILE READY Carson CityE-FILE READY Carsonville, Village ofCONFIRM CHANNEL Caseville TownshipE-FILE READY Caseville, City ofCONFIRM CHANNEL CaspianCONFIRM CHANNEL Cass City, Village ofE-FILE READY Cass County Water SystemE-FILE READY Cass Lakeside SubdivisionCONFIRM CHANNEL CassopolisCONFIRM CHANNEL Cecil FarmsE-FILE READY Cedar Creek TownshipE-FILE READY Cedar Creek Water CompanyE-FILE READY Cedar Hill Assisted LivingE-FILE READY Cedar SpringsCONFIRM CHANNEL Cedarbrook EstatesE-FILE READY Cedarfield Mobile Home ParkCONFIRM CHANNEL Center Line, City ofCONFIRM CHANNEL Central Lake, Village ofE-FILE READY CentrevilleCONFIRM CHANNEL Chalet du Paw Paw CondominiumsCONFIRM CHANNEL Chalet Estates Mobile Home ParkE-FILE READY Charleston TownshipE-FILE READY CharlevoixE-FILE READY Charlevoix TownshipE-FILE READY Charlotte, City ofE-FILE READY Charter Township of AlpenaE-FILE READY Charter Township of DeltaE-FILE READY Charter Township of Grand BlancE-FILE READY Chassell TownshipCONFIRM CHANNEL Chateaux du Lac CondominiumsE-FILE READY ChathamE-FILE READY Cheboygan, City ofE-FILE READY ChelseaCONFIRM CHANNEL Cherry Creek VillageE-FILE READY Chesaning, Village ofE-FILE READY Chesterfield TownshipE-FILE READY Chestnut HillsE-FILE READY Chikaming TownshipE-FILE READY Childs Lake Estates MHCE-FILE READY Chocolay BungalowsE-FILE READY Cidermill CrossingsCONFIRM CHANNEL Circle Drive Mobile Home ParkCONFIRM CHANNEL Clare, City ofE-FILE READY Clarkston Lake EstatesE-FILE READY ClawsonE-FILE READY Clay TownshipCONFIRM CHANNEL Clean Water Association, INC.CONFIRM CHANNEL Clifford, Village ofCONFIRM CHANNEL ClimaxCONFIRM CHANNEL Climax Mobile Home ParkCONFIRM CHANNEL ClintonE-FILE READY Clinton EstatesCONFIRM CHANNEL Clinton TownshipE-FILE READY Clio, City ofE-FILE READY Clyde TownshipE-FILE READY Coachmans CoveE-FILE READY ColdwaterE-FILE READY Coleman, City ofE-FILE READY College Heights Mobile Home ParkCONFIRM CHANNEL ColomaCONFIRM CHANNEL Coloma Charter TownshipE-FILE READY Colombiere CenterE-FILE READY ColonCONFIRM CHANNEL Colonial AcresCONFIRM CHANNEL Colony Bay CondominiumsE-FILE READY Columbia Lakes EstatesCONFIRM CHANNEL Columbiaville, Village ofCONFIRM CHANNEL Commerce TownshipE-FILE READY ConcordE-FILE READY ConstantineCONFIRM CHANNEL Conway Commons Mobile Home ParkE-FILE READY CoopersvilleE-FILE READY Copper CityE-FILE READY Copper MeadowsE-FILE READY Corewell Health-Berrien CntrE-FILE READY Corewellhealth Gr KalamazooE-FILE READY Corunna, City ofE-FILE READY Cottage Cove on Elk LakeCONFIRM CHANNEL Cottage Hs, LLC (pineview Cottage)E-FILE READY Cottrellville TownshipE-FILE READY Country Acres Homeowners AssociationE-FILE READY Country Acres Mobile Home ParkCONFIRM CHANNEL Country Eden L.L.C.CONFIRM CHANNEL Country Hill PinesCONFIRM CHANNEL Country Holiday EstatesCONFIRM CHANNEL Country Living Adult Foster CareE-FILE READY Country Log AptsCONFIRM CHANNEL Country ManorE-FILE READY Country Manor M H PCONFIRM CHANNEL Country MeadowsE-FILE READY Country PlaceCONFIRM CHANNEL Country Place Senior Care CenterCONFIRM CHANNEL Country View Manor CondosCONFIRM CHANNEL Country View Mobile Home CommunityCONFIRM CHANNEL Country Villa EstatesCONFIRM CHANNEL Country VillageE-FILE READY Country Village ApartmentsE-FILE READY Countryside Mobile CourtCONFIRM CHANNEL Countryside VillageE-FILE READY Coventry Woods MHCE-FILE READY Covert TownshipE-FILE READY Cranberry Lake MHCCONFIRM CHANNEL Creekside at Fenton HeightsE-FILE READY Creekside Meadows of ST. JohnsE-FILE READY Creekside MHCCONFIRM CHANNEL Cricklewood CourtE-FILE READY Crockery Mobile Home ParkE-FILE READY Crockery TownshipE-FILE READY Crooked River ApartmentsE-FILE READY Crossroads for YouthE-FILE READY Croswell, City ofE-FILE READY Crystal Downs Mobile VillageE-FILE READY Crystal FallsE-FILE READY Crystal Falls Township - LindCONFIRM CHANNEL Crystal Falls Twp - TownlineCONFIRM CHANNEL Crystal Highlands SubdivisionCONFIRM CHANNEL Crystal Mountain Resort & SpaE-FILE READY Crystal Ridge Condominium AssociationCONFIRM CHANNEL Curry House Assisted Living CenterE-FILE READY Dansville, Village ofCONFIRM CHANNEL Davison, City ofE-FILE READY DearbornE-FILE READY Dearborn HeightsE-FILE READY DecaturE-FILE READY Deckerville, Village ofCONFIRM CHANNEL Deepwater Pointe Master AssociationCONFIRM CHANNEL Deer Park CondominiumsCONFIRM CHANNEL DeerfieldCONFIRM CHANNEL Deerfield Pines Mobile Home ParkE-FILE READY Deerfield VillaE-FILE READY Deerwood SubdivisionE-FILE READY DetourCONFIRM CHANNEL Detroit City ofE-FILE READY DexterE-FILE READY Dimondale Health Care CenterCONFIRM CHANNEL Divine Life of DewittE-FILE READY Djw Properties Mi LLCCONFIRM CHANNEL Dogwood Manor Mobile Home ParkCONFIRM CHANNEL Dorr-LeightonCONFIRM CHANNEL DowagiacE-FILE READY Drummond Island ApartmentsE-FILE READY Dryden, Village ofE-FILE READY Dumont Creek EstatesE-FILE READY DundeeE-FILE READY Dunlops Orchard ParkE-FILE READY Dunrentin Heights SubdivisionCONFIRM CHANNEL Durand, City ofE-FILE READY Dutch HillsCONFIRM CHANNEL Duvernay Park ApartmentsE-FILE READY Eagle Harbor TownshipCONFIRM CHANNEL Eagle Lake CondominiumsCONFIRM CHANNEL Eagle Lake Estates MHPE-FILE READY Eagle Pointe CondominiumsE-FILE READY Eagle Village, INC.E-FILE READY East Bay Charter TownshipE-FILE READY East Bay Mobile Home ParkCONFIRM CHANNEL East Grand RapidsE-FILE READY East Jordan, City ofE-FILE READY East Lansing Meridian Water AuthorityE-FILE READY East Lansing, City ofE-FILE READY East Tawas, City ofE-FILE READY Eastern Mi District Church of NazareneE-FILE READY Eastpointe, City ofE-FILE READY Eaton Green Estates SubdivisionCONFIRM CHANNEL Eaton Rapids, City ofE-FILE READY Eau ClaireCONFIRM CHANNEL EcorseE-FILE READY Edge 72E-FILE READY Edgewood Mobile Home ParkCONFIRM CHANNEL EdmoreE-FILE READY EdwardsburgCONFIRM CHANNEL Egelcraft Mobile Home ParkCONFIRM CHANNEL El Rancho AlansonCONFIRM CHANNEL Elberta, Village ofE-FILE READY Elk Rapids, Village ofE-FILE READY Elkton, Village ofCONFIRM CHANNEL Ellsworth, Village ofCONFIRM CHANNEL Elmwood TownshipE-FILE READY Elmwood Twp - TimberleeE-FILE READY Elsie, Village ofE-FILE READY Ely Township-DioriteCONFIRM CHANNEL Ely Township-GreenwoodCONFIRM CHANNEL Emery PinesE-FILE READY Emmett TownshipE-FILE READY Empire, Village ofE-FILE READY EscanabaE-FILE READY Essexville, City ofE-FILE READY Evart, City ofCONFIRM CHANNEL Evergreen EstatesCONFIRM CHANNEL Evergreen Mobile Home CommunityCONFIRM CHANNEL Evergreen ParkCONFIRM CHANNEL Evergreen Pleasant Valley Trailer ParkE-FILE READY Fairfield TownshipCONFIRM CHANNEL Fairlane EstatesE-FILE READY Fairlawn MeadowsCONFIRM CHANNEL Fairway Lake CondominiumsCONFIRM CHANNEL Farmington Hills, City ofE-FILE READY Farmington, City ofE-FILE READY Farwell, Village ofE-FILE READY FennvilleE-FILE READY Fenton Harbor CondominiumsE-FILE READY Fenton, City ofE-FILE READY FerndaleE-FILE READY FerrysburgE-FILE READY Fife Lake TownhousesE-FILE READY Filer Charter TownshipE-FILE READY Fillmore TownshipCONFIRM CHANNEL First Point Mobile CourtE-FILE READY Flat RockE-FILE READY Flint, City ofE-FILE READY Flushing, City ofE-FILE READY Fonda Lake Water AuthorityCONFIRM CHANNEL Ford Forestry CenterE-FILE READY Ford River TownshipCONFIRM CHANNEL Forester TownshipCONFIRM CHANNEL Forestville Village ofE-FILE READY Forsyth TownshipE-FILE READY Fort Gratiot TownshipE-FILE READY Fowler, Village ofE-FILE READY Fowlerville, Village ofE-FILE READY Foxfield ApartmentsCONFIRM CHANNEL Frankenlust TownshipCONFIRM CHANNEL Frankenmuth TownshipE-FILE READY Frankenmuth, City ofE-FILE READY Frankfort, City ofE-FILE READY Franklin Knolls SubdivisionCONFIRM CHANNEL Franklin TownshipCONFIRM CHANNEL Franklin-Quincy Water AuthorityCONFIRM CHANNEL Fraser TownshipCONFIRM CHANNEL Fraser, City ofE-FILE READY Freeland Mobile Home ParkE-FILE READY FreeportCONFIRM CHANNEL FremontE-FILE READY Frenchtown TownshipE-FILE READY Fruitport TownshipE-FILE READY Fsi Holly Hills Property LLCCONFIRM CHANNEL GaastraE-FILE READY Gagetown, Village ofCONFIRM CHANNEL GalesburgE-FILE READY GardenCONFIRM CHANNEL Garden CityE-FILE READY Garfield Charter TownshipE-FILE READY Garfield OaksE-FILE READY Garland ResortCONFIRM CHANNEL Gaylord, City ofE-FILE READY General White ApartmentsE-FILE READY Genesee County Water SystemE-FILE READY Genesee TownshipE-FILE READY Georgetown TownshipE-FILE READY Germfask TownshipCONFIRM CHANNEL GibraltarE-FILE READY GladstoneE-FILE READY Gladwin Nursing and Rehabilitation CommuCONFIRM CHANNEL Gladwin, City ofCONFIRM CHANNEL Glen Meadows CondominiumsCONFIRM CHANNEL Glen Oaks Community CollegeE-FILE READY Glenn Haven ShoresCONFIRM CHANNEL Glennwoods SubdivisionCONFIRM CHANNEL Glenwood EstatesCONFIRM CHANNEL GoblesCONFIRM CHANNEL Gogebic Range Water AuthE-FILE READY Golden Pond EstatesCONFIRM CHANNEL Grand BeachE-FILE READY Grand Blanc, City ofCONFIRM CHANNEL Grand CountryE-FILE READY Grand HavenE-FILE READY Grand Haven TownshipE-FILE READY Grand Ledge, City ofE-FILE READY Grand Pointe SubdivisionCONFIRM CHANNEL Grand RapidsE-FILE READY Grand Traverse CondominiumsCONFIRM CHANNEL Grand Valley EstatesE-FILE READY Grand Village Mobile Home ParkCONFIRM CHANNEL GrandvilleE-FILE READY GrantE-FILE READY Grant Township - Copper HarborE-FILE READY Grass LakeE-FILE READY Gratiot Area Water AuthorityE-FILE READY Grayling, City ofCONFIRM CHANNEL Great Lakes Adventist AcademyE-FILE READY Great Lakes Water AuthorityE-FILE READY Green Acres Mobile Home ParkCONFIRM CHANNEL Green Brook EstatesCONFIRM CHANNEL Green Oak Twp - Centennial FarmsE-FILE READY Greenbrier EstatesCONFIRM CHANNEL Greenfield EstatesE-FILE READY Greenfield Pointe SubdivisionE-FILE READY Greenlawn Mobile Home CourtCONFIRM CHANNEL Greens Lake ApartmentsE-FILE READY GreenvilleE-FILE READY Gregg ApartmentsE-FILE READY Grosse Ile TownshipE-FILE READY Grosse Pointe FarmsE-FILE READY Grosse Pointe ParkE-FILE READY Grosse Pointe ShoresE-FILE READY Grosse Pointe WoodsE-FILE READY Grosse Pointe, City ofE-FILE READY Groveland ManorCONFIRM CHANNEL Guernsey Lake Mobile Home CommunityE-FILE READY Gun Lake Mobile Home CommunityE-FILE READY Gun Plain TownshipE-FILE READY Gun River Estates WestCONFIRM CHANNEL Gun River Mobile EstatesCONFIRM CHANNEL Gunther Mobile Home Court INCE-FILE READY Hale Creek ManorE-FILE READY Hale Homestead ApartmentsE-FILE READY Hamlet Village Condominiums AssociationE-FILE READY Hamlet West Property Owners AssocE-FILE READY Hamlin Mobile Home ParkE-FILE READY Hampton TownshipCONFIRM CHANNEL HamtramckE-FILE READY

TEST · REPORT · SUBMIT

BackflowGo fills the correct official form for this state and tracks each purveyor's submission channel.