Utica, OH · Licking County
Cross-Connection Control Survey
A company uses this generic survey form to report business details, water connections, equipment, and backflow-prevention information.
What this form is
This generic survey records a company's name, address, business type, contact information, and water meter details. It also asks about existing backflow preventers and equipment or connections involving heating, cooling, pools, tanks, and auxiliary water. The document does not state when the city requires the survey or provide a submission deadline.
Who needs it
A company completing a cross-connection control survey can use this form to provide business, contact, equipment, and backflow-prevention details.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This survey is signed and dated without a notary; it includes surveyor and date fields, and mentions no notarized attachment or sworn step.
How to submit this form
- 1
Download The Survey
Download the Cross-Connection Control Survey PDF.
- 2
Complete Company Details
Enter the company name, address, business type, contact information, and meter details requested.
- 3
Complete The Survey
Provide the requested details about backflow preventers, equipment, and water connections.
- 4
Submit To The City
Submit the completed form to the city department named on it; check the city website for current contact details.
Frequently asked questions
- What information does the Cross-Connection Control Survey request?
- It requests company and business details, contact and meter information, existing backflow-preventer details, and information about equipment and water connections.
- Who uses the Cross-Connection Control Survey?
- A company completing a generic cross-connection control survey can use the form to report its business information and details about equipment, water connections, and backflow preventers.
- Do I need a notary for the Cross-Connection Control Survey?
- No. The survey is signed and dated without a notary; it includes surveyor and date fields and mentions no notarized attachment or sworn step.
- How do I submit the Cross-Connection Control Survey?
- Submit it to the city department named on the form; check the city website for current contact details.