Get the free Cross Connection Control Assembly Removal Notice

Phone: 6082662112 Web: http://dsps.wi.gov Email: dsps@wisconsin.govWisconsin Department of Safety and Professional Services Division of Industry Services 1400 East Washington Avenue PO Box 7302 Madison

How to fill out cross connection control assembly

How to fill out cross connection control assembly:

1. Begin by gathering all necessary information and documentation, such as the assembly's serial number, model number, and any relevant installation or maintenance manuals.
2. Inspect the assembly for any visible signs of damage or wear. If any issues are detected, it is important to address them before proceeding.
3. Locate the appropriate forms or records for documenting the assembly's information. Typically, these forms will include sections for recording the assembly's location, owner, and backflow prevention device details.
4. Start by filling out the general information, such as the name and address of the property where the assembly is installed. Include any relevant contact information for the property owner or responsible party.
5. Refer to the assembly's installation or maintenance manual to accurately identify the specific backflow prevention device installed. Record its model number, manufacturer, and size on the form.
6. Note the assembly's installation date, as well as the date of its most recent test or inspection. If necessary, provide any additional information regarding the maintenance or repairs performed on the assembly.
7. In some cases, additional test measurements or observations may be required. Follow the instructions provided in the installation or maintenance manual to complete these sections accurately.
8. Finally, review the completed form to ensure all necessary information has been recorded accurately. Sign and date the form before submitting it to the appropriate authority or keeping it for your records.

Who needs cross connection control assembly?

1. Properties with a high risk of cross-contamination between potable water and pollutants or contaminants typically require a cross connection control assembly.
2. These may include commercial or industrial facilities that handle chemicals, wastewater, or other potentially harmful substances.
3. Additionally, certain residential buildings, such as multi-family dwellings or buildings with shared amenities, may also require cross connection control assemblies to protect their water supply from potential contamination.

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What is cross connection control assembly?

Cross connection control assembly is a device that prevents the backflow of contaminated water into the public water supply.

Who is required to file cross connection control assembly?

Property owners or businesses with potential cross connections are required to file cross connection control assembly.

How to fill out cross connection control assembly?

Cross connection control assembly forms can be filled out online or submitted in person to the local water authority.

What is the purpose of cross connection control assembly?

The purpose of cross connection control assembly is to protect the public water supply from contamination.

What information must be reported on cross connection control assembly?

Information such as the location of the assembly, type of backflow device, and date of installation must be reported on cross connection control assembly.