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Residential Cross-Connection Survey

Please correct the field(s) marked in red below:

By submitting this survey you certify under penalty of law, that the following information is, to the best of your knowledge and belief, true, accurate, and complete.
1
Contact Information
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Contact Information
2
Does the property have auxiliary water such as Wenatchee Reclamation Irrigation Water or a private well?
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Does the property have auxiliary water such as Wenatchee Reclamation Irrigation Water or a private well?
3
Does the property have an underground lawn sprinkler system?
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Does the property have an underground lawn sprinkler system?
4
Does the property have a sprinkler system using both City and Reclamation water?
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Does the property have a sprinkler system using both City and Reclamation water?
5
Does the property have a lawn irrigation system using chemicals, fertilizer, or has a booster pump?
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Does the property have a lawn irrigation system using chemicals, fertilizer, or has a booster pump?
6
Does the property have a swimming pool or hot tub with auto water fill?
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Does the property have a swimming pool or hot tub with auto water fill?
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Does the property have a water connected cooling system?
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Does the property have a water connected cooling system?
8
Does the property have a water connected greenhouse?
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Does the property have a water connected greenhouse?
9
Does the property have a water softener?
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Does the property have a water softener?
10
Does the property have a water connected fire suppression system?
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Does the property have a water connected fire suppression system?
11
Does anyone at the property use portable dialysis equipment?
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Does anyone at the property use portable dialysis equipment?
12
Does the property have a laboratory or photo processing equipment?
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Does the property have a laboratory or photo processing equipment?
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Does the property have water connected radiant floor heat?
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Does the property have water connected radiant floor heat?
14
Is a high temperature pressure washer used on the property?
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Is a high temperature pressure washer used on the property?
15
Are there any other processes connected to the City of Wenatchee water supply on the property?
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Are there any other processes connected to the City of Wenatchee water supply on the property?
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For any questions with a "yes" answer - is that plumbing connection protected with a backflow assembly?  Please list in the comment section below.
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For any questions with a "yes" answer - is that plumbing connection protected with a backflow assembly? Please list in the comment section below.
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Comments:
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