Commercial, Industrial and Public Authority

Commercial, Industrial and Public Authority  Cross Connection Program

The Wisconsin Department of Natural Resources requires the Neenah Water Utility to enforce cross connection backflow compliance of Commercial, Industrial and Public Authority properties every 2 years to ensure the safety of your water supply. To fulfill requirements of DNR Code 810.15 the Compliance Statement and Existing Devices Forms must be completed.  Compliance is mandatory.

A cross connection survey is an inspection of the water system piping in a building or property, starting at the water meter and ending at the last free flowing tap as required by the Department of Safety and Professional Services 382.41.  Backflow prevention devices will need to be installed at the owner’s expense where current or potential unprotected cross connections exist.

Submit Forms by Mail: Submit Forms by E-mail (pdf):
Neenah Water Utility
Attn: Cross Connection Program
211 Walnut Street
Neenah, WI 54956
water@ci.neenah.wi.us

 

Compliance Statement

Complete the Cross Connection Compliance Statement in its entirety to satisfy part 2.A. of the Compliance Statement. Properties with DSPS Registered devices must submit copies of the test results to satisfy part 2. B. Fill out the Existing Devices Form to satisfy part 2. C.  Incomplete forms will not be accepted.Sample Existing Devices Form

 

 

 

 

 

 

 

Existing Devices Form

Fill out the Existing Devices Form to satisfy part 2. C. of the Compliance Statement. List every device that is used to control cross connections.

 

Click here for Compliance Statement and Existing Devices Forms.