Cross-Connection Control Survey

Dear Water Customer,

The purpose of this survey is to determine whether a cross-connection may exist at your home or business. A cross connection is an unprotected or improper connecion to the public water distribution system, that may cause contamination or pollution to enter the system. The IEPA and Illinois Dept. of Public Health are responsible for enforcing cross-control regulations.

*Every customer served by the public water system must be surveyed. This survey includes identifying what plumbing fixtures are present in the home or business, and what uses the water is being put to. Please take a moment to complete the following survey.

Thank you,
John W. Pruden, Public Works Director
City of Salem

**This survey is required by the Illinois Environmental Protection Agency and must be completed by all water customers.**




Cross-Connection Control Survey
Thank you, your survey is complete. Please click the submit button below.
Data from this form may be used to determine if the property should be inspected by a licensed plumber to detect and correct any cross connections found on the property.