Get the free Cross Connection Device Permit Application April 2012 - cityofwestfield

City Of Westfield Massachusetts WATER RESOURCES DEPARTMENT 28 Hackett Street, Westfield, MA 01085 (413) 5726243 CROSS CONNECTION CONTROL PROGRAM Backflow Prevention To: Backflow Prevention Installers

How to fill out cross connection device permit

How to fill out a cross connection device permit:

1. Obtain the necessary forms from your local government or water authority. They may have a specific application form for cross connection device permits.
2. Carefully read and understand the instructions provided with the application form. Make sure you have all the required information and documents before proceeding.
3. Fill in the applicant's information section. Provide your name, address, contact information, and any other details requested.
4. Identify the cross connection device you intend to install or modify. Provide detailed information about the device, including its make, model, and purpose.
5. Describe the location where the cross connection device will be installed. This should include the address, specific room or area, and any other relevant details.
6. Provide a brief explanation of why you require the cross connection device permit. Explain the purpose or need for the device and its intended function.
7. If necessary, attach any supporting documents or drawings that may be required. These could include plumbing plans, device specifications, or other relevant information.
8. Review the completed application form for accuracy and completeness. Double-check that all required sections have been filled out correctly.
9. Sign and date the application form. Some permits may require additional signatures from property owners, contractors, or other individuals involved in the installation or modification process.
10. Submit the application form to the appropriate authority. Follow the instructions provided to determine the submission method, whether it's online, by mail, or in person.

Who needs a cross connection device permit?

1. Plumbers and contractors: Individuals who install or modify cross connection devices as part of their professional work typically require a permit. This ensures that the work is carried out to proper standards and regulations.
2. Property owners: If you plan to install a cross connection device on your property, you may need to obtain a permit. This helps verify that the installation complies with safety and plumbing requirements.
3. Some industries or businesses: Depending on the nature of their operations, certain industries or businesses may require a cross connection device permit. This is particularly common for facilities that handle potentially hazardous materials or have complex plumbing systems.
4. Municipalities and water authorities: In some cases, government bodies may require permits for cross connection devices installed on their properties or included in public water systems. This helps ensure the integrity and safety of the public water supply.

For pdfFiller’s FAQs

What is cross connection device permit?

A cross connection device permit is a document that allows an individual or company to install, maintain, and monitor cross connection control devices in a water system to prevent contamination.

Who is required to file cross connection device permit?

Any individual or company that owns or operates a water system with cross connection control devices is required to file a cross connection device permit.

How to fill out cross connection device permit?

To fill out a cross connection device permit, the individual or company must provide information about the water system, the types of cross connection control devices installed, and any testing or maintenance schedules.

What is the purpose of cross connection device permit?

The purpose of a cross connection device permit is to ensure that water systems are properly protected from contamination by requiring the installation and maintenance of cross connection control devices.

What information must be reported on cross connection device permit?

The information that must be reported on a cross connection device permit includes the location of the water system, the types of cross connection control devices installed, and any testing or maintenance records.

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