Cross Connection Control Survey
The City of Hickory Hills (City) is responsible for delivering safe drinking water to the public. The City is required by the Illinois Environmental Protection Agency to survey all water services connected to our public drinking water supply by developing and implementing a backflow prevention program.

This program mandates that we survey all water customers to identify actual and potential cross connections that may exist at your home or business. A cross connection is a connection between a potable water supply and a non-potable source, where a contaminant potentially could enter the drinking water supply. You might know your backflow devices by their more common names of RPZ (Reduced Pressure zones) or DC (double check valves).

Your cooperation is essential. All water customers are required to complete and return this survey by paper or electronic form. The survey below should take less than 10 minutes of your time. Thank You.
Today's Date *
Name *
Address *
Telephone Number
Please check the box(es) that best describes the use of water at your residence. (Check all that apply) *
Do you have any backflow prevention devices installed on your plumbing system? *
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