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Village of East Troy's Cross Connection Control Plan Cross Connection Control Program Page 1TABLE OF CONTENTS Purpose 11Responsibilities111AuthorityIVDefinitionsVDegree of Hazard and Approved DevicesVIAdministration
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How to fill out s cross connection control:

01
Begin by gathering all necessary information and documentation related to the cross connection control program. This may include previous reports, inspection forms, and relevant permits or licenses.
02
Familiarize yourself with the specific regulations and standards set forth by your local governing authority or regulatory agency. Ensure you are aware of any updates or changes to the requirements for cross connection control.
03
Start by identifying all potential cross connections in your facility or system. This involves locating any points where potable (drinking) water may come into contact with non-potable sources, such as industrial fluids or chemicals.
04
Document each identified cross connection, including its location, purpose, and potential risks associated with it. This could involve creating a cross connection control survey or inventory form, where you list all relevant details for each cross connection.
05
Based on the risks associated with each cross connection, classify them into different hazard levels. This will help prioritize your control measures and determine the appropriate level of protection required for each cross connection.
06
Assess and document the existing control measures in place to prevent backflow or contamination. This may include backflow prevention devices, air gaps, or check valves. Make sure you review and verify the proper functioning and maintenance of these measures.
07
Develop a comprehensive plan for cross connection control that includes preventive and corrective measures. This plan should outline the strategies and actions required to protect the potable water supply from potential contamination or backflow incidents.
08
Implement the control measures identified in your plan. This may involve installing additional backflow prevention devices, conducting regular inspections and testing, or providing training and awareness programs for employees.
09
Regularly review and update your cross connection control program to ensure its effectiveness and compliance with regulatory standards. This includes conducting periodic risk assessments, maintaining up-to-date records, and addressing any identified issues or deficiencies promptly.

Who needs s cross connection control?

01
Water utilities and public water systems: These organizations are responsible for providing safe and clean drinking water to the public. They must have a cross connection control program in place to protect the integrity of the water supply.
02
Industrial facilities: Businesses or industries that use non-potable water sources or engage in activities that pose a risk of contaminating the water supply require cross connection control. This includes factories, chemical plants, hospitals, and laboratories.
03
Residential and commercial properties: Buildings with plumbing connections that could potentially introduce contaminants or backflow into the municipal water system should have a cross connection control program. This includes multi-unit residential complexes, hotels, restaurants, and schools.
04
Health and safety organizations: Regulatory agencies responsible for water quality and public health often mandate the implementation of cross connection control programs. These organizations ensure that the necessary measures are in place to protect public health and prevent waterborne illnesses.
05
Individuals: Even homeowners should be mindful of potential cross connections within their plumbing systems. Residential properties with private wells or alternative sources of water should have appropriate backflow prevention devices to safeguard their drinking water.
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Cross connection control is a method to prevent contaminated water from flowing back into the clean water supply.
Businesses and facilities that have potential cross connections are required to file a cross connection control program.
To fill out a cross connection control form, you must identify potential cross connections, assess the risks, and implement control measures.
The purpose of cross connection control is to protect the public water supply from contamination.
The report must include a list of potential cross connections, a risk assessment, and details of control measures.
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