Sample Letter of Acknowledgment for Field Evaluation Sites

(Revised 10 October 2019)

REQUIRED TO BE SUBMITTED ON COMPANY LETTERHEAD

10/10/2019

Field Evaluation Coordinator

USC Foundation Laboratory

3022 Riverside Drive

Los Angeles, CA 90039

Re: Field Evaluation Test Site

MANUFACTURER

MODEL, SIZE

It is the understanding of PROPERTY OWNER, WATER SUPPLIER, OR HEALTH AGENCY that the subject test backflow prevention assembly(s) (assembly(s)) to be located at LOCATION ADDRESS will be in the field for at least twelve (12) months1 and during that time the assembly(s) will be tested on a nominal thirty (30) day schedule by the USC Foundation for Cross-Connection Control and Hydraulic Research (USC Foundation) at the University of Southern California. A normal test will usually require a shutdown of water from five to ten minutes, however during these tests the water service may be turned off for an hour or more for inspection or maintenance. During the period of the Field Evaluation, only the Foundation staff is permitted to test, inspect, or repair the assembly(s). The manufacturer may consider the data generated during the Foundation Evaluation process (and in some cases the existence of the product) to be confidential. It is, therefore, necessary for all persons present during the Field Evaluation process to agree not to disclose information relating to such equipment.

The subject test assembly(s) location shall be reviewed and deemed acceptable by the Foundation prior to the installation. The Foundation Staff will only perform the initial field test after the assembly has successfully completed the Laboratory Evaluation. The manufacturer of the assembly(s) will be responsible for any required water/health agency field testing and maintenance of the assembly(s) installed prior to the initial field test.

At the successful conclusion of the Field Evaluation phase of the Foundation Approval program, the assembly(s) will gain USC Approval and become the property of PROPERTY OWNER. Should the subject assembly(s) not complete the Field Evaluation and not gain USC Approval, then the manufacturer of the subject assembly(s) will be responsible for replacing the field test assembly(s) with a USC approved assembly(s).

Sincerely,

SIGNATURE

PRINTED NAME

TITLE

cc.	MANUFACTURER

PROPERTY OWNER

WATER SUPPLIER

HEALTH AGENCY