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AZ TRT/DOC/00337 - City of Phoenix 2025 free printable template

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This document is a report used to test and certify backflow prevention assemblies, detailing the tests conducted, results, and necessary repairs.
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A backflow prevention assembly test is a process used to ensure that devices designed to prevent the reverse flow of contaminated water into potable water systems are functioning correctly. This testing is critical to protect public health and maintain water quality.
Typically, property owners or managers whose properties have backflow prevention devices are required to file backflow prevention assembly tests. This may also include businesses that handle hazardous materials and are required by local regulations to ensure their water supply is protected.
To fill out a backflow prevention assembly test, one must complete a standardized form that includes information such as the type of assembly tested, test results for each check valve, the tester's name and certification number, the date of the test, and any observed deficiencies or required repairs.
The purpose of the backflow prevention assembly test is to verify that backflow prevention devices are operating effectively to prevent the contamination of the drinking water supply, ensuring the safety and health of the public.
The information that must be reported on a backflow prevention assembly test includes the location of the assembly, type and model of the device, test results for each component of the assembly, any repairs made, the tester's certification details, and the date of the test.
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