Commercial Cross-Connection Survey

If you have questions please contact 208-522-1300, email at fallswater@fallswater.com or visit the Falls
Water’s website at fallswater.com. Thank you for assisting in compliance with State of Idao public water supply
regulations and protecting Falls Water’s drinking water. 

Click here to see print-out version of this survey.

    First name: Last Name: Phone number: Email Address: Company name: OwnerTenantBoth Account Number: Water Service Address: Water Service City: Water Service State: Water Service Zip Code: Phone Number: Date: (Required) When completing the survey, please indicate if the listed cross connection is present and if it is protected with a backflow device. Thank you for assisting in compliance with State regulations and protecting Falls Water’s drinking water. 1. Auxiliary water source water such as a well used for irrigation Is Connection Present? YesNo
    Is Connection Protected with backflow? YesNo
    2. Auxiliary water source used for geothermal heating or cooling Is Connection Present? YesNo
    Is Connection Protected with backflow? YesNo
    3. Underground lawn irrigation system Is Connection Present? YesNo
    Is Connection Protected with backflow? YesNo
    4. Lawn irrigation system using chemicals, fertilizer, or has a booster pump