Cross Connection Control Survey

THE CITY OF TUSCOLA (IL) WATER DEPARTMENT IS REQUIRED BY THE ILLINOIS EPA TO CONDUCT A SURVEY OF POTENTIAL CROSS CONNECTIONS TO OUR WATER SYSTEM.

YOUR COOPERATION AND ASSISTANCE IS REQUIRED BY STATE LAW AND APPRECIATED BY THE CITY OF TUSCOLA

A cross connection is a connection to the public water supply, through private plumbing, of any other contaminant or non-potable water, or other type of backflow onto the public water system.

This questionnaire will assist us in ensuring our public water supply is safe from outside contaminants. The survey will take only a few minutes for most people.

Thank you for your cooperation in completing the survey!

Name of person completing this survey

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Water Service Address

Enter the address in Tuscola, IL where you have water services as shown on your water bill

Do you own or rent this property?

Property Owner of Record Name

How is water used at this address?

Choose Typical Household/domestic use if no commercial, industrial, agricultural, medical or other use

Please describe any use of water at this location that is other than typical household/domestic use. Note type of use if commercial, agricultural, industrial, medical or other uses.

Leave Blank if water usage is typical household use

Does this location have a well?

Is the well attached in any way to the plumbing system that is attached to the public water supply?

Does this location have an underground lawn sprinkling system?

Is the lawn sprinkling system connected in any way to the public water supply?

Does this location have a fire suppression (sprinkler) system?

Is the fire suppression (sprinkler) system connected in any way to the public water supply?

A fire suppression (sprinkler) system connected to the public water supply is typically required to have a backflow prevention device installed. Does your system have a backflow prevention device installed?

The Illinois Plumbing Code does provide for a fire suppression system installation that can be connected to the public water supply and NOT be installed with a backflow prevention device. Those systems would meet have to meet ALL of the following criteria:

A looped system with no dead ends
A system having no connections other than the public water supply
A system having less than 20 sprinkler heads
And a system constructed with water supply quality pipe

If your system meets all of those requirements, and you do not have, and are not otherwise required to have a backflow prevention device, simply completing the survey and certifying these facts with the City of Tuscola Water Department is sufficient to comply with the Cross Connection Rules.

My fire suppression system meets the following requirements:

Is there a Pool, hot tub, pond or spa at this property?

Residents are required to use a safe method when filling a pool, hot tub, pond, or spa with water from the public water supply. The easiest and least expensive way to comply is to use a simple air gap method of preventing water backflow when filling, as illustrated here:
Air Gap Illustration

Alternatively, a homeowner can have a backflow prevention device installed and have it professionally inspected annually. A copy of the annual inspection must be filed with the City of Tuscola for all backflow prevention devices.

I will use this method of safe filling for any pool, hot tub, pond or spa:

Does this location currently have any type of backflow prevention device (RPZ) installed? Backflow devices are required to be inspected annually by a certified inspector.

If Yes (you do have a backflow prevention device installed), describe the type of device, size and location.

Upload a copy of your most recent annual inspection of the backflow prevention device. Alternatively, you can submit a copy to City Hall Water Department 214 N Main ST, Tuscola, IL 61953

City of Tuscola, Illinois

Cross Connection Control