Five Elements

1. Local Authority

2. Public Education and Awareness

  • Tracking Form - Template
  • WATTS Informative Information
  • Thermal Expansion Education - Template
  • CCR (Consumer Confidence Report). If your annual CCR has Cross Connection Control language in it, highlight it and put it in this section. (Get help from RWAU to complete your CCR by calling Shantell Cummins 801.642.2421)
  • Anything that you have done or used for Public Education & Awareness (handouts, website information, postings. etc) should go in this section - Handout Template

3. Trained/Certified Staff

  • ‚ÄčTrained/Certified Staff Tracking Form - Template 
  • Certificates (you should also include a copy of any Cross Connection 101, Backflow Tester/Technician, and/or Cross Connection Administrator certification in this section)
  • Visit our RWAU Training page to see when the next Cross Connection classes are being held

4. Written Records

5. On-going Enforcement

  • Enforcement Tracking Form - Template
  • Hazard Assessment Form - Template
  • Hazard Assessment Notices & Test Notice/Letter - Template
  • Test Reports/Forms: These forms are usually available at the local city or town building department office in a triplicate form type. This way the backflow technician who tested the backflow assembly can provide the water customer and the city or town office a copy, as well as keep a copy for her/his records.
  • Residential Survey Questionnaire - Template
  • List of Certified Backflow Assembly Testers in the area. (You may get a list from the DDW's Backflow webpage.)

Submit your Cross Connection Control Program to the Utah Division of Drinking Water

Division of Drinking Water's Cross Connection Webpage Use our Cross Connection Control Program Cover Page to get your CCC Program submitted to the right person. -Template

Improvement Priority System (IPS)

It's important to know if your water system as Cross Connection Control Program Deficiency Points on your IPS -

click here to check 

5 elements total at 10 points EACH!