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Cross Connection Control Survey

  1. Dear Water Customer,

    The Illinois Environmental Protection Agency (IEPA) requires that all water systems conduct a biennial survey of the water system to determine where cross connections exist. Cross connections within the public water supply are a serious concern, as they can allow contaminants or pollutants to enter the public water system through backflow. This survey is an important component of the IEPA and City of Wheaton’s Cross Connection Control Program. The information obtained is used to ensure safe drinking water for all users by documenting whether a building has certain devices, such as a lawn irrigation system, or whether a backflow prevention device is currently installed. In accordance with IEPA regulations and to help prevent the dangers that exist from unprotected cross connections, it is necessary to complete and return a survey for your service location.

    Should you have any questions regarding this program, please contact the City of Wheaton’s Water Division at 630-260-2090. Form not displaying correctly? Use the PDF version.

  2. Type of Property:

  3. Check All that Apply:

  4. Boiler (for heat)

  5. Backflow preventer?

  6. Lawn Irrigation System

  7. Backflow preventer?

  8. Fire Sprinkler System

  9. Backflow preventer?

  10. Swimming Pool/Hot Tub

  11. Backflow preventer?

  12. Water-powered Sump Pump

  13. Backflow preventer?

  14. Pond/Fountain

  15. Backflow preventer?

  16. Private Well

  17. Backflow preventer?

  18. Chemicals (Commercial)

  19. Backflow preventer?

  20. Backflow Prevention Devices:

  21. Leave This Blank:

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