Northlake, TX · Denton County
Backflow Device Test Report
Certified testers use this report to record a backflow prevention assembly’s test results, repairs, device details, and certification for the Town of Northlake.
What this form is
This report records information about a backflow prevention assembly and certifies that it was tested and maintained according to the stated TCEQ regulations. It asks for the device location and hazard, assembly and test details, repairs, test-gauge information, and the certified tester’s signature, name, and test date; it also says to keep test records for at least three years.
Who needs it
A certified tester completing and certifying a backflow prevention assembly test report for a device in Northlake needs this form.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details. The report does not provide a submission address or method.
About notarization
This report has no notary block; the certified tester signs and dates it, and no notarized or sworn attachment is identified.
How to submit this form
- 1
Download The Report
Download the Backflow Device Test Report PDF.
- 2
Complete The Device Details
Enter the device address and location, hazard description, assembly information, and test results.
- 3
Record Tester Information
Include repair and test-gauge details, then have the certified tester sign, print their name, and enter the test date.
- 4
Submit The Report
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Backflow Device Test Report?
- No. The report has no notary block; the certified tester signs and dates it. The document identifies no notarized or sworn attachment.
- How do I submit the Backflow Device Test Report?
- The report does not give a submission address or method. Submit it to the city department named on the form and check the city website for current contact details.
- What information does the report request?
- It requests the device address and location, hazard description, assembly and test details, repairs, test-gauge information, and the certified tester’s signature, name, and test date.
Need something notarized?
This Backflow Device Test Report doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.