Vote
Survey
Pay My Bill
Home
About
History
Board of Directors
Staff Members
General Information
Cross-Connection Control Program Policy
Lead Service Line Inventory
Calendar and Rates
Bylaws
Toilet Rebate Program
Irrigation Rain Sensor Rebate
Rules and Regulations
Non-Payment
Drought Action Plan
Completed Projects
Lead/Copper Sample Testing
How Are Water Rates Determined
Articles of Incorporation
Combined Lot Policy and Application
Plumbers List
BOD Meeting Information
Board Agenda & Minutes
BLSMWC Bubbler
Meeting Schedule
Reports
CCWD Water Purchase Agreement
General Manager’s Report
President’s Report
Treasurer Letter/Budget
Standing Committees, Members & Lead
LRPC Committee Report
Water Quality Report
Tips
Frequently Asked Questions
How to Read Your Meter
Call Before You Dig
Indoor Tips
Irrigation Tips
Outdoor Tips
Using Graywater
Winterizing Your Home
Bark Beetle Information
Contact
General Contact Info
Billing Questions
Emergency Hotline
Employment
Pay My Water Bill
Vote
Cross Connection Control Survey
Home
Cross Connection Control Survey
Step
1
of
2
50%
Blue Lake Springs Mutual Water Company is conducting a survey that is required by the State Drinking Water Division to collect the following information from our shareholders. This information will help protect your plumbing and our potable water system from potential sources of cross contamination.
What is a cross connection?
Cross connections are actual or potential connections between a potable water system and any source of contamination including an auxiliary water source. A cross connection makes it possible for contaminated material to enter into the drinking water supply when the pressure of the contaminating source is greater than the pressure of the water supply. This can result in either back-siphoning or backflow, causing a reversal in the normal direction of water flow. It is our goal to ensure the Blue Lake Springs Mutual Water Company will never have a backflow problem that could be harmful to our community. However, if a potential backflow problem exists, it is important for the health and safety of our shareholders to comply by completing this survey.
Typed Name of Shareholder
(Required)
First
Last
Service Address
(Required)
Email
(Required)
Survey questions:
If you answer “Yes” to any of the questions below, please describe.
Do you have any other source of water such as a well, pond, or storage tank connected to the plumbing system at this address?
(Required)
Yes
No
If yes, please describe:
(Required)
Is there a fire suppression system at this address?
(Required)
Yes
No
If yes, please describe:
(Required)
Is there a landscaping sprinkler system connected to the plumbing system?
(Required)
Yes
No
If yes, please describe:
(Required)
Is there a swimming pool or hot tub connected to the plumbing system at this address?
(Required)
Yes
No
If yes, please describe:
(Required)
Are there solar hot water heating panels connected to the plumbing at this address?
(Required)
Yes
No
If yes, please describe:
(Required)
Are there process systems or chemical systems connected to the plumbing at this address?
(Required)
Yes
No
If yes, please describe:
(Required)
Is there a grey water system connected to the plumbing system at the address?re process systems or chemical systems connected to the plumbing at this address?
(Required)
Yes
No
If yes, please describe:
(Required)
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.
Menu
Cross Connection Control Survey
Click Here
×