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Cross-Connection Control Residential

  1. Are you the property owner?

  2. Please indicate which of the following you have:

  3. Alternate Water Source*

  4. If yes, please indicate which source you have

  5. Boiler or Steam Heat*

  6. If yes, please indicate boiler type

  7. Fire Sprinkler Protection System*

  8. Lawn Irrigation System*

  9. Shampoo Bowl/Sink*

  10. Swimming Pool/Hot Tub*

  11. Other Equipment with a Direct Connection to City Water*

  12. Do you have backflow preventers on your property?*

    Backflow Preventer

  13. Pictures of devices in question can be e-mailed for review by the City’s Plumbing Inspector. The City’s Plumbing Inspector can also be contacted via phone at 309.524.2374.

  14. Leave This Blank:

  15. This field is not part of the form submission.