Get the free Cross connection agreement - Gallatin Public Utilities

GALLATIN PUBLIC UTILITIES Water Sewer & Natural Gas 239 Hancock Street Gallatin, TN 37066 Phone: 6154515922 Fax: 6154520568 CrossConnection Control Device Installation and Testing Agreement Date:

How to fill out cross connection agreement

How to fill out a cross connection agreement:

1. Begin by obtaining a copy of the cross connection agreement form. This form can typically be obtained from your local water utility or plumbing department.
2. Read the instructions carefully to understand the purpose and requirements of the agreement.
3. Identify the parties involved in the cross connection, including the property owner or tenant, the water supplier, and any other relevant parties.
4. Fill out the agreement form accurately and completely. Provide all required information such as names, addresses, and contact details of the involved parties.
5. Specify the details of the cross connection, including the location and purpose of the connection, and any specific equipment or devices involved.
6. Include information about the backflow prevention measures that will be implemented to protect the water supply from contamination. This may include details about the type of backflow prevention assembly to be installed, its maintenance schedule, and required testing procedures.
7. Review the completed agreement form thoroughly to ensure all information is accurate and all necessary sections have been filled out.
8. Sign the agreement form, making sure all relevant parties sign where required. Some agreements may also require notarization or witnessing.
9. Submit the completed agreement form to the designated authority, such as the water utility or plumbing department. Follow any specific submission instructions provided.
10. Keep a copy of the filled-out agreement form for your records.

Who needs a cross connection agreement:

1. Property owners or tenants who have or plan to have a cross connection between their plumbing system and a public water supply.
2. Water utilities or authorities responsible for maintaining the public water supply and ensuring its protection from contamination.
3. Regulatory agencies or governing bodies that establish and enforce regulations related to cross connections and backflow prevention.
4. Various industries and businesses that may be required to have a cross connection agreement in place due to the nature of their operations, such as restaurants, car washes, medical facilities, or manufacturing plants.
5. Plumbers or contractors involved in the installation or maintenance of plumbing systems that may have cross connections.
6. Homeowners associations or property management companies that oversee multiple properties and ensure compliance with cross connection control measures.

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What is cross connection agreement?

A cross connection agreement is a contract between two parties outlining the responsibilities and regulations for preventing the contamination of potable water.

Who is required to file cross connection agreement?

Property owners, businesses, or individuals that have potential cross connections and backflow prevention devices are required to file a cross connection agreement.

How to fill out cross connection agreement?

To fill out a cross connection agreement, one must provide information about the property, potential cross connections, backflow prevention devices, and contact information.

What is the purpose of cross connection agreement?

The purpose of a cross connection agreement is to protect the public water supply from contamination by ensuring that proper backflow prevention measures are in place and being maintained.

What information must be reported on cross connection agreement?

Information such as property address, potential cross connections, backflow prevention devices, and contact information for responsible parties must be reported on a cross connection agreement.