Rock Falls, IL · Whiteside County
Residential Cross Connection Control Survey
Rock Falls water customers complete this survey to report household plumbing, water-use features, and possible connections to the city water system.
What this form is
The City of Rock Falls uses this survey to conduct its cross-connection control survey every three years. City water users report information such as boilers, pools, wells, irrigation systems, backflow devices, and water service line material. The form requests the customer’s name, service address, contact details, and information about household water uses and connections.
Who needs it
City of Rock Falls water users complete the survey with details about their service address and household water systems.
How to submit it
Return the completed survey to the Utility Billing Office, mail it to City of Rock Falls Utility Office, 603 W 10th St., Rock Falls, IL 61071, or email [email protected].
About notarization
No notary is required; the person completing the survey provides the requested date, and no sworn or notarized attachment is identified.
How to submit this form
- 1
Download the Survey
Download the Residential Cross Connection Control Survey for City of Rock Falls water users.
- 2
Complete the Survey
Provide customer and service address details, then answer the questions about household water systems and uses.
- 3
Check for Attachments
The survey does not identify any required attachments.
- 4
Return It to the City
Deliver it to the Utility Billing Office, mail it to the listed Utility Office address, or email it to [email protected].
Frequently asked questions
- What does the Residential Cross Connection Control Survey ask?
- It asks for customer and service address details, household water-use features, possible connections to the city water system, backflow devices, and water service line material.
- Who completes this survey?
- The survey is for City of Rock Falls water users. The person completing it provides their name and title, daytime phone number, service address, and requested household information.
- How do I submit the Residential Cross Connection Control Survey?
- Return it to the Utility Billing Office, mail it to City of Rock Falls Utility Office, 603 W 10th St., Rock Falls, IL 61071, or email [email protected].
- Do I need a notary for the Residential Cross Connection Control Survey?
- No. The person completing the survey provides the requested date; the document identifies no sworn or notarized attachment.