An ordinance regulating cross connections with the public water supply system, i.e., a connection or arrangement of piping or appurtenances through which water of questionable quality, wastes or other contaminants can enter the public water supply system.

Be it ordained by (the council of the city or the village, township board, or other legislative body operating a public water supply), State of Michigan:

Section 1. That the (city, village, or township) adopts by reference the Water Supply Cross Connection Rules of the Michigan Department of Public Health being R 325.11401 to R 325.11407 of the Michigan Administrative Code.

Section 2. That it shall be the duty of the (name of local agency) to cause inspections to be made of all properties served by the public water supply where cross connections with the public water supply is deemed possible. The frequency of inspections and reinspections based on potential health hazards involved shall be as established by the (name of water utility) and as approved by the Michigan Department of Public Health.

Section 3. That the representative of the (name of local inspection agency) shall have the right to enter at any reasonable time any property served by a connection to the public water supply system of (city, village, or township) for the purpose of inspecting the piping system or systems thereof for cross connections. On request, the owner, lessees, or occupants of any property so served shall furnish to the inspection agency any pertinent information regarding the piping system or systems on such property. The refusal of such information or refusal of access, when requested, shall be deemed evidence of the presence of cross connections.

Section 4. That the (name of water utility) is hereby authorized and directed to discontinue water service after reasonable notice to any property wherein any connection in violation of this ordinance exists and to take such other precautionary measures deemed necessary to eliminate any danger of contamination of the public water supply system. Water service to such property shall not be restored until the cross connection(s) has been eliminated in compliance with the provisions of this ordinance.

Section 5. That the potable water supply made available on the properties served by the public water supply shall be protected from possible contamination as specified by this ordinance and by the state and (city, village, or township) plumbing code. Any water outlet which could be used for potable or domestic purposes and which is not supplied by the potable system must be labeled in a conspicuous manner as:

WATER UNSAFE

FOR DRINKING

Section 6. That this ordinance does not supersede the state plumbing code and (city, village, or township plumbing ordinance No. _____ ), but is supplementary to them.

Section 7. That any person or customer found guilty of violating any of the provisions of this ordinance or any written order of the (name of inspection agency or name of water utility), in pursuance thereof, shall be deemed guilty of a misdemeanor and upon conviction thereof shall be punished by a fine of not less that ( $ ) nor more than ( $ ) for each violation. Each day upon which a violation of the provisions of this act shall occur shall be deemed a separate and additional violation for the purpose of this ordinance.

APPENDIX B - OUTLINE OF LOCAL PROGRAM

I. Introduction - Why, what, when

II. Local ordinance

III. Designate local inspection and/or enforcement agencies

-How staffed

-Numbers

-Training

IV. Schedule for inspections

A. Special concern

1. Known or suspected secondary supply: surface water, Class III wells, recirculated water

2. Known or suspected submerged inlet

B. Area review - if one vicinity of community is likely to be more critical, it will be reviewed first . . . the remainder following in logical sequence.

V. Schedule for reinspection - why? -- Sample schedule in manual adopted or adopted with changes, additions .

VI. Methods to protect against hazards of cross connections .

VII. Time allowed for correction

A. Items of extreme hazard - disconnect immediately and so maintain until necessary corrections have been made.

Example: Surface water not separated from potable water.

B. Time required to obtain necessary protective devices and install.

VIII. Testing of devices, test reports

A. Frequency required

B. Qualifications of tester

C. Results

D. Repairs made

IX. Collect sufficient data to complete annual report to the Michigan Department of Public Health and to monitor program adequately from within.

I. Introduction

In accordance with the requirements set forth by the Michigan Department of Public Health, the village (city, township) of _________________________ has officially adopted the state of Michigan cross connection control rules to protect the _________________________ public water supply system. Cross-Connection" is defined as a connection or arrangement of piping or appurtenances through which a backflow could occur. "Backflow" means water of questionable quality, waste, or other contaminants entering a public water supply system due to a reversal of flow. The cross connection control program will take effect immediately upon approval of the Michigan Department of Public Health.

II. Local Ordinance

The authority to carry out and enforce a local cross connection control program will be in accordance with village (city, township) ordinance No. ____________ a copy of which is included in the program. (See page 67 of the Cross Connection Rules Manual.)

III. Local Inspection

The water superintendent and/or his designated agent shall be responsible for making the initial cross connection inspections and reinspections to check for the presence of cross connections with the municipal water supply system. Individuals responsible for carrying out the cross connection inspections and reinspections shall have obtained necessary training through any available manuals on cross connection prevention, including the Cross Connection Rules Manual as published by the Michigan Department of Public Health and attendance of any cross connection training sessions sponsored by the Michigan Department of Public Health or other recognized agencies.

IV. The schedule for inspections shall be in accordance with the following general outline:

1. Known or suspected secondary water supply cross connections shall be inspected first (surface water, Class III wells, recirculated water, etc.)

2. Known or suspected submerged inlet cross connections will be inspected next.

In general, emphasis will be placed on making inspections initially of all industrial and commercial establishments or where cross connections are known or suspected to exist. A general area review will follow in a logical sequence as time permits. Emphasis will be placed on inspecting all industrial and commercial establishments within a period of six months following approval of this program.

V. Schedule for Reinspection

In order to assure against the hazards of cross connections, it will be necessary to periodically and systematically reinspect for the presence of cross connections. The schedule for reinspection shall be in accordance with the schedule as noted on page of the Cross Connection Rules Manual.' Whenever it is suspected or known that modifications have taken place with piping systems serving a particular water customer, reinspections of the premise will be made.

VI. Protective Devices

The methods to protect against the hazards of cross connections as outlined on pages and of the Cross Connection Rules Manual will be incorporated into the village (city, township) cross connection control program. Whenever any deviation from the recommended methods of protection is contemplated, approval from the Michigan Department of Public Health shall first be obtained.

VII. Compliance Time

The time allowed for correction or elimination of any cross connection found shall be as follows:

I. Cross connections which pose an eminent and extreme hazard shall be disconnected immediately and so maintained until necessary protective devices or modifications are made.

2. Cross connections which do not pose an extreme hazard to the water supply system, but nevertheless constitute a cross connection should be corrected within a reasonable period of time. The length of time allowed for correction should be reasonable and, may vary depending on the type of device necessary for protection. The water utility shall indicate to each customer where a cross connection is found to exist, the time period allowed for compliance (30 to 60 days is usually sufficient time for small devices).

VIII.

All reduced pressure principle backflow prevention devices shall be tested at least every months with records of test results maintained by the water utility. Only individuals approved by the water utility shall be qualified to perform such testing. That individual(s) shall certify the results of his testing.

IX.

The water utility shall maintain sufficient and accurate records of its local cross connection control program so as to report annually on the status of the local program to the Michigan Department of Public Health on a form provided by the department.

NAME DATE____________________________________

LOCATION INSPECTOR_________________________________

TITLE______________________________

USER'S CLASS: (Industry, commercial, educational residence, etc. WATER SOURCE___________________________

USER'S REPRESENTATIVE_____________________________________

I.Is there any type of secondary water supply within the user's property?

A) Surface water______________

B) Recirculated_______________

C) Well supply, Class I, II, III

D) Other (describe)___________________________

Is there any critical equipment within plant, i.e., FURNACE, COMPRESSOR, BOILER, which must have water at all times?______ If so, where?______________

II. Cross connection by submerged inlet?

A) Commercial boilers_______________________ D) Plating tanks________________

B) Autopsy or mortuary tables_______________ E) Lawn sprinkling_____________

C) Medical, pathology or research F) Photo labs_________________

chemical and/or bacteriologic labs________

III. Cross connection with piping which may contain sanitary waste or a chemical

contaminant?

A) Piping for fire protection____________ C) Refrigeration system_____________

B) Equipment drained to sewer____________ D) Other__________________________

RECOMMEND PROTECTION

1) Air-Gap____ 2) R.P.B.P.____ 3) Vacuum Breaker____ 4) Pressure Vacuum Breaker______

COMMENTS AND STIPULATIONS

NAME________________________________________ DATE_________________________________

LOCATION____________________________________ INSPECTOR____________________________

USER'S CLASS_____________________________ TITLE_____________________________

WATER SOURCE_________________________________

Reinspection of recommended protective devices? Yes ( ) No ( ) If YES, record what you found.__________________________________________________

Reinspection requested? Yes ( ) No ( )

Results:

APPENDIX E - TEST PROCEDURES FOR BACKFLOW PREVENTION DEVICES

TEST NO. 1

Purpose

To test check valve No. I for tightness against reverse flow and operation of pressure differential relief valve.

Requirement

Check valve must be tight against reverse flow under all pressure differentials and relief valve must operate to maintain the zone between the two check valves at least 2 psi less than the supply pressure.

Steps

1. Blow down test cocks No. 2, No. 3, and No. 4 to remove any foreign material. Do not stand directly in front of test cocks when turning them off or on; they may blow off and inflict injury.

2. Connect test equipment to device by attaching hose from high pressure side of gauge to test cock No. 2 and hose from low pressure side of gauge to test cock No. 3.

3. Open test cocks No. 2 and No. 3 and bleed air through control valves on gauge.

4. Close shut-off valve No. 2 and note differential pressure reading on gauge. Gradually increase pressure in zone of reduced pressure by bypassing water from test cock No. 2 through control valve to test cock No. 3 until water begins to drip from the pressure differential relief valve. Note pressure differential reading on gauge. If water is released from the relief valve at or above a differential pressure of 2 psi, the relief valve is operating properly.

5. Re-establish pressure across check valve No. 1 by opening and closing test cock No. 4 or shut-off valve No. 2. If there is no drainage from pressure differential relief valve at this point, check valve No. 1 is closed tight.

TEST NO. 2

Purpose

To test check valve No. 2 for tightness against reverse flow.

Requirement

Check valve must be tight against reverse flow under all pressure differentials.

Steps

1. Bleed air from bypass hose and connect to test cock No. 4, open test cock No. 4.

2. Bypass water from test cock No. 2 to test cock No. 4. If pressure differential between zone of reduced pressure and test cock No. 2 remains constant and there is no discharge from relief valve, No. 2 check valve is closed tight.

3. Return shut-off valves to original position and remove test equipment.

TEST NO. 1

Purpose

To test No. I check valve for tightness against reverse flow.

Requirement

Valve must be tight against reverse flow under all pressure differentials,

Steps

1. Blow down test cocks to remove any foreign materials. Do not stand directly in front of test cocks when turning them off or on; they may blow off and inflict injury.

2. Install duplex pressure gauge, attaching hoses to test cocks No. 2 and No. 3.

3. Open control cocks and bleed air from hoses.

(NOTE: Bleeding air from the hoses is important. Entrapped air could result in false readings.)

4. Close shutoff valve No. 2.

5. Close shutoff valve No. 1.

6. Drain slowly from control cock No. 2 until gauge at test cock No. 2 reads 2 psi less than gauge at test cock No. 3. Close control cock. If both gauges hold the established differential pressure, the check valve shall be noted in the report as "Closed Tight".

NOTE:

If both gauges drop simultaneously and no differential is maintained, the check valve may be leaking. Confirm by:

a. Adjust the pressure within the backflow device (by opening gate valve No. 1, or bleeding from a control cock) to be about 10 psi less than the supply line pressure.

b. Install bypass between test cock No. 1 and control cock (shut) at gauge on test cock No. 3.

c. Open test cock No. 1.

d. Slowly open both control cocks simultaneously so the 10 psi lower pressure is maintained on gauge at test cock No. 2. If a continuous flow of water occurs from the control cock at test cock No. 2, the check valve is leaking.

TEST NO. 2

Purpose

To test No. 2 check valve for tightness against reverse flow.

Requirement

Valve must be tight against reverse flow under all pressure differentials.

Steps

1. Open shutoff valve No. I and re-establish pressure in the device.

2. Attach hoses to test cocks No. 3 and No. 4.

3. Follow same procedure as in Test No. I, starting with Step No. 3 and substituting test cocks No. 3 and No. 4 for test cocks No. 2 and No. 3.

4. Return shutoff valves to original positions and remove test equipment.

ALTERNATE PROCEDURE

Purpose

To test No. 1 and No. 2 check valves for tightness against reverse flow.

Steps

1. Using a 3 ft. section of hose, connect it between test cocks No. 1 and No. 2.

2. Close gate valve No. 1 and No. 2.

3. Open test cocks No. 1 and No. 3.

4. Slowly open test cock No. 2. Other than initial leakage, if there is no further flow from test cock No. 2, then check valve No. I is tight.

5. If leakage continues from test cock No. 2, then check valve No. I is leaking (see service instructions).

6. Close all test cocks and place hose between test cocks No. 1 and No. 4.

7. Open test cocks No. I and No. 4.

8. Slowly open test cock No. 3. Other than initial leakage, if there is no further flow from test cock No. 3, then check valve No. 2 is tight.

9. If leakage continues from test cock No. 3, then check valve No. 2 is leaking (see service instructions).

1. Remove canopy from top of vacuum breaker to expose air inlet tube.

2. Close shutoff valve No. B on discharge side of vacuum breaker.

3. Close shutoff valve No. A on inlet side of vacuum breaker.

4. Slowly open test cock No. 2, watching guide in air inlet tube. Valve must be fully open by the time the water stops running from test cock No. 2. If it is not open, then air inlet is sticking and valve must be repaired.

5. Close test cock No. 2.

6. Install sight tube at test cock No. 1.

7. Open valve No. A to allow unit to refill with water.

8. Open test cock No. 1 and allow sight tube to fill about 30 inches above top of unit, then close test cock.

9. Close valve No. A (valve No. B should already be closed).

10. Open test cock No. 1.

11. Open test cock No. 2. Water may run from test cock No. 2 initially, but should not continue. The level of water in the sight tube may drop a little, but should not drop below 27 inches above the check valve (centerline of the discharge gate valve). If the level in the sight tube continues to drop and water continues to run out of test cock No. 2, the check valve is leaking and should be repaired.

12. Close test cocks No. 1 and No. 2.

NOTE:

Open shutoff valve No. B on the discharge side of the vacuum breaker before opening the shutoff valve No. A. This eliminates any shock that might cause the diaphragm to blow due to the compressed air and resultant shock wave.

Rule 325.11405 of the Water Supply Administrative Rules states in part that "a water utility shall report annually to the Department of Public Health on the status of the cross connection control program on a form provided by the department." Below is the annual report form which must be completed by the water utility and returned to this department by February , 19

A. Name of water utility _____________________________________________________

B. Year in which local cross connection control program was formally started: _______

C. Total number of industrial, commercial, institutional, and miscellaneous accounts which must be inspected for cross connections: _______________

D. Total number of accounts of those listed in "C" above which were inspected

in 19 _______________

E. Total number of accounts of those listed under "C" which have been inspected at least once since beginning the local cross connection control program: ___________

F. Number of accounts from "E" above where a cross connection(s) was found to exist: ______________

G. Number of accounts from "F" above where corrective actions has been completed: ________________

H. Total number of accounts from "E'1 which are now in compliance with the local cross connection control program: ________________

I. Number of reinspections required each year based on approved frequency for

reinspection: ________________

J. Number of reinspections from above which were made in 19 : ______________

Narrative Description of Program

(outline briefly any changes or significant findings since last reporting; use additional sheets if necessary.)

Signature________________________________________________

Title______________________________ Date________________

Please submit the completed report by February , 19 to:

Michigan Department of Public Health - or - Michigan Department of Public Health

Division of Water Supply Northern Peninsula Division

3500 North Logan St., P.O. Box 30035 315 Ludington Street

Lansing, MI 48909 Escanaba, MI 49829

Industrial fire protection Systems consist of sprinklers, hose connections, and hydrants. Sprinkler systems may be dry or wet, open or closed. Systems of fixed-spray nozzles may be used indoors or outdoors for protection of flammable liquid and other hazardous processes. It is standard practice, especially in cities, to equip automatic sprinkler systems with fire department pumper connections.

For cross connection control, fire protection systems may be classified on the basis of water source and arrangement of supplies as follows:

Class 1 - direct connections from public water mains only; no pumps, tanks, or reservoirs; no physical connection from other water supplies; no anti-freeze or other additives of any kind; all sprinkler drains discharging to atmosphere, dry wells, or other safe outlets.

Class 2 - same as Class 1, except that booster pumps may be installed in the connections from the street mains (booster pumps do not affect the potability of the system; it is necessary, however, to avoid drawing too much water that pressure in the water main is reduced below 10 psi).

Class 3 - direct connection from public water supply mains plus one or more of the following: elevated storage tanks, fire pumps taking suction from above-ground covered reservoirs or tanks; and pressure tanks. (All storage facilities are filled or connected to public water only, the water in the tanks to be maintained in a potable condition. Otherwise, Class 3 systems are the same as Class 1.)

Class 4 - directly supplied from public mains similar to Classes 1 and 2 and with an auxiliary water supply on or available to the premises; or an auxiliary supply may be located within 1,700 feet of the pumper connection.

Class 5 - directly supplied from public mains and interconnected with auxiliary supplies, such as pumps taking suction from reservoirs exposed to contamination, or rivers and ponds; driven wells; mills or other industrial water systems; or where anti-freeze or other additives are used.

Class 6 - combined industrial and fire protection systems supplied from the public water mains only, with or without gravity storage or pump suction tanks.

Generally, fire protection systems of Classes 1 and 2 will not require backflow protection at the service connection. Pumper connections of automotive fire department equipment to street hydrants are not ordinarily health hazards.

Class 3 systems will generally require minimum protection (approved double check valves) to prevent stagnant waters from backflowing into the public potable water supply.

Class 4 systems will normally require backflow protection at the service connection. The type (air gap, reduced pressure, or double check valves) will generally depend on the quality of the auxiliary supply.

Class 5 systems normally would need maximum protection (air gap or reduced pressure) to protect the public potable water system.

Class 6 system protection would depend on the requirements of both industry and fire protection, and could only be determined by a survey of the premises.

*NOTE: The State Plumbing Code of Michigan (BOCA 1990 Edition with Part 7 amendments) requires that a reduced pressure zone (RPZ) backflow preventer be installed on the water supply piping upstream of any fire department pumper connection whenever there is a common potable water connection serving the premise. The Plumbing Code requirement does not apply to piping systems used only for fire protection supplied by a separate building service.