Cross Connection Control Survey

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The Illinois Environmental Protection Agency (IEPA) requires that all water suppliers in the State of Illinois have an effective Cross Connection Control / Backflow Prevention Program. The purpose of the program is to protect public health and to protect our public water supply by preventing backflow of contaminants back into the potable water system. More information on the Village’s Cross Connection Program, can be found on the Village’s website at http://www.villageoflagrange.com/crossconnection.

One requirement of the program is to send a biennial cross connection survey to all water customers. The purpose of the survey is to update existing inventory of cross connection devices and to determine if other cross connection devices exist. Below is a survey that we are requesting you complete and submit to the Village. If you have any questions related to the program or this survey, please contact Mike Bojovic, Assistant Director of Public Works at (708) 579-2328. Thank you for your cooperation.


CUSTOMER INFORMATION






WATER USE SURVEY

















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