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Posted on: February 13, 2020

Cross-Connection Survey

Complete and Return Your Cross-Connection Survey Today

Utility customers received a Cross-Connection Survey Form enclosed with the January Utility bills. To those of you who returned the form, thank you! Your information will help prevent the accidental contamination of our drinking water system.

If you misplaced your form, it’s not too late to pick up the reporting form at the Customer Service office or download it here. Requests for forms or additional information also can be emailed to WaterSystem@fremontne.gov.

State law requires consumers of public water supplies to inspect their facilities not less than every five years. Completing and returning the form fulfills that requirement. If you completed and returned a form five years ago and you have made no plumbing changes, sign, and return the form.

The backside of the form explains the potential hazard to the public water system if back-siphonage or backflow devices are not installed on private water systems. Potential sources are underground lawn irrigation systems, swimming pools, hot tubs, lab facilities, private wells or other sources of water, boiler heat or water to air heat pumps, garden hoses connected to possible contaminants, water softeners, and booster pumps.

If you have questions regarding the Cross-Connection form, contact Keith Kontor or Mike Parde at 402.727.2613 at the Utility Service Center.

Cross Connection Survey Form

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