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Industries: Medical and Dental

Medical and Dental Office Plumbing in Phoenix

Amalgam separators, the city paperwork behind them, backflow for clinics and the plumbing an operatory needs, explained for practice managers across the Valley.

Short answer

A Phoenix-area dental office must run an amalgam separator that meets the EPA Dental Amalgam Rule, file a one-time compliance report with its sewer utility, and keep three years of separator records. Medical and dental buildings in Phoenix also need an air gap or reduced pressure backflow assembly on the water service, tested every year.

The rules that apply

Each rule links to the official text we read it from. Cities change these, so check the source before a big decision. Last checked 2026-09-29.

Amalgam separator

Federal (Phoenix enforces)

Dental offices that place or remove amalgam must remove amalgam solids from all amalgam process wastewater with a separator certified to ANSI/ADA 108 or ISO 11143 (at least 95 percent removal), sized for the maximum discharge rate.

Source: 40 CFR 441.30

Older separators

Federal

A separator installed before June 14, 2017 counts as compliant until it is replaced or until June 14, 2027, whichever comes first. A broken separator is repaired or replaced within 10 business days of finding the problem.

Source: 40 CFR 441.30(a)(1)(iii) and (v)

One-Time Compliance Report

Phoenix

File the report with the City of Phoenix, the Control Authority, within 90 days of first discharge for a new office or 90 days after a change of ownership. Exempt specialties and offices that don't place amalgam still file one.

Source: Phoenix Dental Amalgam Rule FAQs

Separator records

Federal

Keep inspection dates and results, container replacements, amalgam pickups, and every separator repair or replacement for at least three years, plus the manufacturer's operating manual for the current unit.

Source: 40 CFR 441.50(b)

Line cleaners

Federal

Chair-side traps, vacuum lines and dental unit water lines that drain to the sewer can't be cleaned with oxidizing or acidic cleaners, such as bleach, chlorine, iodine or peroxide, below pH 6 or above pH 8.

Source: 40 CFR 441.30(b)

Service backflow

Phoenix

Hospitals, medical buildings, clinics and research laboratories need an air gap or reduced pressure (RP) assembly. Every assembly is tested at least once a year by a certified tester and the results go to the city.

Source: Phoenix City Code 37-143 and 37-144

Secondary RP assembly

Phoenix

Under Phoenix's 2024 IPC amendments, hospitals, surgical clinics, medical buildings and laboratories get a secondary reduced pressure assembly as close as practicable to each point of service delivery.

Source: Phoenix amendment to IPC 608.7.2

Amalgam traps

Gilbert

Anyone using silver amalgam installs amalgam traps on all equipment that might carry amalgam waste to the sewer, and cleans or replaces them per the manufacturer without letting captured waste into the sewer.

Source: Gilbert Town Code 66-248

Amalgam separators: what the EPA rule actually asks

Any dental office that places or removes amalgam fillings and drains to a city sewer needs an amalgam separator. The EPA's Dental Amalgam Rule (40 CFR Part 441) requires one or more separators that meet ANSI/ADA Specification 108 or ISO 11143, with at least 95 percent removal, sized for the office's maximum flow. Existing offices had to comply by July 14, 2020. New offices comply from the first day they discharge.

A few offices are outside the rule. Practices that do only oral surgery, orthodontics, periodontics, prosthodontics, oral pathology or oral radiology are exempt, and so are mobile units. Offices that don't place amalgam and remove it only in rare emergencies can certify that instead. The City of Phoenix flyer adds a useful line: an office that stocks amalgam capsules clearly intends to place amalgam.

Watch the calendar on older equipment. A separator installed before June 14, 2017 is grandfathered only until June 14, 2027, or until it has to be replaced, whichever comes first. If yours predates 2017, plan the swap now instead of during a busy week next spring.

Gilbert adds its own line: Town Code 66-248 requires amalgam traps on all equipment that might carry amalgam waste to the sewer.

Paperwork the city expects

In Phoenix, the city's Water Services Department is the Control Authority, so the One-Time Compliance Report goes to its Environmental Services Division. A new office files within 90 days of first sending wastewater to the sewer. A new owner files within 90 days of the sale, even when nothing in the operatory changed.

After that, the rule is about records. Keep these for at least three years:

  1. 1The date, the person and the result of each separator inspection.
  2. 2Every canister or container replacement.
  3. 3Each amalgam pickup or shipment, and the disposal facility that took it.
  4. 4Any repair or replacement of the separator, with make and model.

Keep the manufacturer's operating manual on hand too. And check what goes down the vacuum lines: bleach, chlorine, iodine and peroxide line cleaners outside pH 6 to 8 are banned on lines that drain to the sewer. The Phoenix industrial wastewater permit page covers the city's wider pretreatment program.

Backflow for clinics and medical buildings

Phoenix puts medical buildings on its list of facilities that need backflow protection. City Code 37-144 lists hospitals, medical buildings, clinics, nursing homes and research laboratories among the facilities that need an air gap or a reduced pressure (RP) assembly on the water service. Phoenix's 2024 plumbing code amendments go further and call for a secondary RP assembly at hospitals, surgical clinics, medical buildings and labs.

Every assembly is tested at least once a year by a certified tester, and the customer sends the results to the city and keeps records three years. Inside the suite, the 2024 IPC also requires backflow protection on the water supply to dental pumping equipment. Not sure which assembly you have? Here's RPZ vs double check, and what happens when an assembly fails its test.

Vacuum, compressor and sterilizer plumbing

Dental and medical suites carry plumbing a normal office never sees. Sterilizers that discharge potable water to the drain do it through an indirect waste pipe with an air gap under the 2024 IPC, so a drain backup can't reach the sterilizer. Vacuum pumps, compressors and cuspidors each have water feeds and drains that need to be where the equipment maker's drawings say.

Two local wrinkles. Phoenix amended IPC 803.1 so corrosive waste has to be neutralized or treated by an approved device, and notes that diluting chemical waste instead is prohibited under 40 CFR 403.6(d). Paradise Valley requires dental vacuum piping under an on-grade slab to follow drawings from a registered design professional. The takeaway: plan the under-slab work before the concrete, not after.

Tenant improvements and permits

Opening or expanding a practice in Phoenix means a permit. The city's building code requires one before you install, alter or replace a plumbing system, and its short list of exemptions covers small repairs, not new chairs, sinks or equipment rooms. Phoenix does let you repair or replace an existing secondary backflow assembly of 2 inches or smaller without a permit, as long as a certified tester's report goes to the city. See the Phoenix commercial TI permit page and commercial tenant improvement plumbing.

How HQ works with medical and dental offices

We clear commercial drains and jet lines, replace backflow assemblies, install water heaters, run gas lines, and camera and repair sewer lines. We work around patient hours, including evenings and weekends, and we're available 24/7 for a backup that can't wait. You get an upfront price before work starts, and estimates are free.

FAQ

Medical and Dental Offices: common questions

Anything else, call (602) 675-1555.

How often does a commercial backflow preventer need testing in Arizona?

At least annually. Arizona rules require a certified tester to check each commercial backflow assembly once a year, and again after any install, relocation, or repair. In Phoenix you file results by the date the city sets, and fire system results are due within 30 days.

Read full answer: How often does a commercial backflow preventer need testing in Arizona?
RPZ vs double-check backflow assembly: what's the difference?

Both stop water from flowing backward into the clean supply, but they fit different risk levels. A double-check assembly suits low-to-medium hazard, non-health cross-connections. An RPZ adds a relief valve for high-hazard, health connections, making it the strongest protection. The hazard level decides which one code requires.

Read full answer: RPZ vs double-check backflow assembly: what's the difference?
My backflow assembly failed its test. What happens next?

The assembly has to be repaired or replaced, retested by a certified tester, and a passing report filed with your water provider by its deadline. Most failures are fixed by cleaning or rebuilding the check valves or relief valve. Mesa wants repairs done by the compliance date, and Scottsdale gives 45 days after its notice.

Read full answer: My backflow assembly failed its test. What happens next?
Who is allowed to test backflow assemblies in Arizona?

A certified general backflow tester. Arizona's rule requires certification from a body ADEQ approves, which today are CA-NV AWWA, ABPA, ASSE-IAPMO and All American Backflow Prevention. Most Valley water providers also require the tester to be on their own recognized list, with a calibrated test kit. A test by anyone else won't count.

Read full answer: Who is allowed to test backflow assemblies in Arizona?
Where do I send backflow test reports in the Phoenix area?

Send the report to the water provider on your water bill, not to the state. Phoenix takes reports at Backflow.Prevention@phoenix.gov, Scottsdale at backflowtesting@ScottsdaleAZ.gov, Mesa through its backflow portal, and EPCOR at crossconnection@epcor.com. Filing deadlines depend on the provider and assembly type. Your tester usually files it, but confirm receipt.

Read full answer: Where do I send backflow test reports in the Phoenix area?
What happens if I miss my Phoenix backflow test deadline?

Under City Code 37-146, Phoenix can shut off your water after 10 days written notice, or right away if your system could be a health hazard. It can also add up to 1,000 percent to your water charges per billing period. Service comes back only after the test is done and you pay the city's costs and penalties.

Read full answer: What happens if I miss my Phoenix backflow test deadline?
What plumbing is involved in a commercial tenant improvement (TI)?

A commercial tenant improvement is the build-out of a leased space for a new tenant. The plumbing depends on the use, but it often means relocating or adding fixtures, floor sinks and drains, a grease interceptor, a water heater, ADA restrooms, and backflow protection, all under a city permit.

Read full answer: What plumbing is involved in a commercial tenant improvement (TI)?
Commercial plumbing repairs: tenant or landlord responsibility?

It depends on the lease. There is no single rule. A triple-net (NNN) lease usually puts day-to-day interior plumbing on the tenant, while the landlord keeps structural, roof, and central systems. A gross lease usually puts maintenance on the landlord. The repair clause in your actual lease decides.

Read full answer: Commercial plumbing repairs: tenant or landlord responsibility?
Why does my commercial building smell like sewer gas?

Most often a dried-out trap. Low-use restrooms, mop sinks, mechanical rooms, and seldom-used floor drains lose the water seal in their P-traps to evaporation, which is fast in Phoenix, and sewer gas rises in. Refill the traps with water; install trap seal primers on drains that keep drying out.

Read full answer: Why does my commercial building smell like sewer gas?
What are the different types of commercial water heaters?

Commercial buildings use five main types: storage tank (gas or electric), tankless or on-demand units, tankless racks for high demand, heat pump units, and a boiler with an indirect storage tank. Point-of-use heaters serve remote sinks. The right choice depends on peak demand and the temperature you need.

Read full answer: What are the different types of commercial water heaters?
What should a commercial plumbing preventive maintenance plan include?

A commercial plumbing preventive maintenance plan should schedule grease interceptor service at the applicable buildup threshold or required interval, whichever comes first, an annual backflow assembly test, periodic drain and sewer jetting with a camera inspection, water heater flushing, fixture and flushometer checks, shutoff valve mapping, pressure checks, and leak monitoring.

Read full answer: What should a commercial plumbing preventive maintenance plan include?

Other industries we serve

Restaurants

Grease interceptor rules by city, pumping schedules, health code plumbing and soda backflow, plus 24/7 kitchen drain service.

Apartments and Multifamily

Arizona landlord plumbing duties, kitchen stack clogs, water heaters, planned shutoffs, backflow testing and sewer laterals.

Property Managers and Retail Centers

Shared grease interceptors, strip center backflow, tenant improvement permits, vacant suite odors and the records cities ask for.

Hotels and Motels

County hotel plumbing rules, pool and spa backflow, laundry lint interceptors and hot water for the morning rush, plus 24/7 repair.

Breweries and Bars

Brewery backflow, sewer pH and temperature limits, carbonator RPs, bar floor sinks, glass washers and trench drain jetting.

Schools and Colleges

Lab backflow, lead testing at fountains, cafeteria grease interceptors, worn restrooms and summer break maintenance for Valley campuses.

Churches and Houses of Worship

Dry traps, fellowship hall kitchen grease, restroom loads on event days and irrigation backflow for Valley houses of worship.

Gyms and Fitness Centers

Locker room showers, hair-clogged drains, sewer smells from dry traps and pool and spa plumbing rules for Valley gyms.

Salons and Barbershops

State board hot water and drain rules, shampoo bowl clogs, hair interceptors, chemical dispenser backflow and salon water heaters.

Laundromats and Commercial Laundries

Lint interceptor rules, city cleaning records, laundry backflow, water heaters sized for peak demand and sewer line care.

Car Washes

Sand and oil interceptor rules, 12-month pumping, three-year records, RP backflow and bay and reclaim line jetting.

Warehouses and Industrial

RP backflow for multi-tenant shells, oil separators at truck bays, tempered eyewash water and industrial wastewater permits.

HOAs and Condo Associations

Condo vs owner plumbing duties, shared sewer lines, irrigation backflow testing, community pools and emergency water shutoffs.

Plumbing Help for Medical and Dental Offices

Talk to a real dispatcher who knows commercial work. Upfront pricing before work starts, 24/7 for emergencies.