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Application Form CrossConnection Control Specialist Public List 331476 Revised January 2022Form Submission Purpose (double click to activate the checkboxes.) Add my name to the list. Complete all
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A cross-connection control specialist public is a professional certified to identify, manage, and prevent potential cross-connections in a public water supply system.
Individuals or organizations that provide public water services and implement cross-connection control programs are required to file as cross-connection control specialists.
To fill out the cross-connection control specialist public form, provide the required personal and organizational information, certification details, and outline the cross-connection control measures in place.
The purpose is to protect public health by preventing contamination of the drinking water supply through backflow caused by cross-connections.
Information that must be reported includes the specialist's credentials, the public water system details, risk assessment results, and the measures taken to control cross-connections.
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