RESIDENTIAL SURVEY FORM FOR THE WATER SYSTEM OF Lower Platte North NRD
The Lower Platte North RWD is required by State law to develop and implement a “cross-connection control program.” The purpose of this program is to help protect public health by preventing pollution and/or contamination of the drinking water as it is delivered to your home.
As part of our efforts to keep your drinking water safe, Lower Platte North RWD is conducting a cross-connection control survey of residential and commercial customers of our systems. The purpose of the survey is to help us determine if backflow preventers or other measures may be necessary at your connection point to prevent pollution and/or contamination of our water system.
State law requires consumers of public water supplies to inspect their facilities not less than once every five years. Completing & returning this form fulfills that requirement.
Completion of this form is a condition of water service!
Required fields are marked with *.
Thank you! By completing this form, you will help prevent the accidental contamination of our drinking water.
If you have any questions, contact Mike Sousek at firstname.lastname@example.org or call (402) 443-4675.