RPZ Valve Install Application

We are required to provide consent before you install an RPZ valve. Please complete the form below.

{panel-id} Your details

The asterisk (*) symbol denotes required fields.

Customer/Company name *

Please enter a valid customer/company name

Telephone number *

Please enter a valid telephone number

Email address *

Please enter a valid email address

Company address and postcode *

Please enter your description

Please state the name and contact details of the person who will be responsible for organising the commissioning and annual testing of the RPZ valve.

Name of responsible party *

Please enter a valid name of responsible party

Telephone number *

Please enter a valid telephone number

Email address *

Please enter a valid email address

Name and address of Company seeking consent (if different from above).

Name, address, and postcode

Please enter your description

Telephone number

Please enter a valid telephone number

Email address

Please enter a valid email address

{panel-id} Your RPZ valve

The asterisk (*) symbol denotes required fields.

If this application is being made in connection with a letter we have sent you following an inspection, please quote the reference number stated on the letter.

Reference number

Please enter a valid reference number

Make of intended RPZ valve *

Please enter a valid make of intended rpz valve

Model of intended RPZ valve *

Please enter a valid model of intended rpz valve

Size of intended RPZ valve *

Please enter a valid size of intended rpz valve

Please provide your intended location, type, and use of the plant/equipment which the proposed RPZ valve is to supply

Installation details *

Please enter your description

Please confirm the method of water supply to the valve.

Please select a title

Is this a temporary or permanent arrangement?

Please select a title

{panel-id} Your plan

The asterisk (*) symbol denotes required fields.

Please upload a sketch or plan of the proposed installation showing both the proposed RPZ valve and the plant/equipment which the RPZ valve will supply.

File must be no larger than 5 MB.

Select File Please upload a file

{panel-id} Confirmation

The asterisk (*) symbol denotes required fields.

By ticking the box below, you are confirming that the information you have provided is correct and accurate at the time of submission, and you accept our terms and conditions.

Your data will be stored and used in line with our privacy policy.

Please tick *

Please agree to our terms and conditions