Survey or Owner Checklist

Note: the following is a list of typical cross connections that could exist in a facility and is meant to assist you in determining whether an actual or potential cross connection exists. This list of facilities and/or cross connections should not be considered as all-inclusive.

Cross connections at sanitary or storm sewers; water pumps or connections used for priming, cleaning, flushing, unclogging purposes; water operated sewage/sump ejectors. Cross connections for the purpose of disposing of filter or softener backwash; water connections from cooling systems or for blowing out obstructions in sewer lines; water connections to greywater/reclaimed water systems.

Cross connections at reservoirs, cooling towers and circulating systems that may be heavily contaminated with bird droppings, vermin, algae, bacterial slimes or with toxic water teratment compounds.

Tanks, lines, valves, fittings and other equipment being subjected to hydraulic test. Hydraulically operated equipment where city water pressure is used directly and may be subject to backpressure or hydraulic fluid. Equipment under hydraulic tests where pumps, rams, pressure cylinders are used to provide pressures for testing purposes.

Industrial fluid systems or any other type of system containing cutting or hydraulic fluids, coolants, glycol, caustic or acid solutions, etc.

Fire fighting systems, including storage reservoirs which may be treated for prevention of scale formation, corrosion, algae, slime growth, etc. Fire systems, which may be subject to contamination with anti-freeze solutins or other chemicals or chemical compound used in fighting fires. Fire systems, which may be subject to contamination with auxiliary water supplies or an industrial fluid.  Wet fire systems containing no chemicals.

Plating facilities involving the use of highly toxic cyanides, heavy metals in solution and caustic or acid solutions.  Plating solution filtering equipment with pumps and circulating lines.  Tanks, vats or any other container used in painting, descaling, cleaning, stripping, oxidizing, etching, dipping or rinsing operations.

A steam generating or boiler facility, which could contaminate the water supply with boiler compounds or any chemical additive.

Inadequately protected flush valve toilets, urinals, aspirators and similar contaminated and/or sewer connected fixture or appliance. Laboratory equipment, which may be chemically or bacterically contaminated such as steam sterilizers, autoclaves, specimen tanks, autopsy and mortuary equipment, fume hoods, lab faucets, pipette washers (these could include dental offices, medical clinics, veterinary facilities, mortuaries, hospitals, universities, colleges, schools, laboratories). Other cross connections can include baptisteries, hose bibbs in any location, trap seal primers, water conditioning equipment, pressure washers, RV or marine pump stations, etc.

Cross connections at tanks, automatic film processing machines or other equipment or facility used in processing films, which may be contaminated with chemicals.

Laundry machines having under rim or bottom inlets, dye vats in which are used toxic chemicals or dyes, wash water storage tanks equipped with pumps and recirculating systems, retention and mixing tanks; shrinking, bluing and dying machines with direct connections to circulating systems, detergent dispensers, dry cleaning equipment, etc.

Cross connections at dish/glass washers, hood wash downs, beverage carbonators, icemakers, detergent dispensers, etc.

Pressure cookers, autoclaves, washers, cookers, tanks, lines and other equipment used for storing, washing, cleaning, blanching, cooking, flushing or for transmission of foods or wastes.

Water supplies or sources of water not under the control of City of Peterborough.

Combination heating systems which utilize chemical additives, having heating lines that are not circulated for extended periods of time, or are not of double wall construction. Geo thermal or heat pump systems utilizing chemical additives.

Solar energy systems that may employ anti-freeze solutions or chemical inhibitors for hot water heating, space heating, industrial process water heating; swimming pool water which may have cross connections with the domestic water system.

Areas exempt from local inspection provisions (building code or local By-law) or areas not accessible for inspections.

The use of this list and that of Appendix B, Backflow prevention Device Selection Guide, of the Cross Connection Control Program (CCCP) will guide you in the selection of the appropriate backflow prevention device.

It is not a requirement that this list be submitted with Appendix B of the CCCP, however it may assist the Cross Connection Control Officer with the review of the surveyors recommendations for compliance with the CCCP. 

Should you have any questions please contact David Young at 705-748-9301 extension 1349 or by email at dpyoung@peterborough.ca