2025/06/10 City Council Resolution 2025-038 RESOLUTION NO. 2025-038
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF ROHNERT PARK
ADOPTING A NEW CROSS-CONNECTION CONTROL PLAN FOR THE CITY
OF ROHNERT PARK PURSUANT TO THE CALIFORNIA STATE
WATER RESOURCES CONTROL BOARD'S CROSS-CONNECTION
CONTROL POLICY HANDBOOK
WHEREAS, the California Code of Regulations, Title 17, requires public water systems
to protect the potable water supply from contamination by implementing and maintaining an
effective cross-connection control program; and
WHEREAS, the California State Water Resources Control Board("SWRCB") issued the
Cross-Connection Control Policy Handbook("Handbook") in 2023, establishing new minimum
statewide standards for cross-connection control programs; and
WHEREAS, the Handbook requires public water systems to adopt or revise their Cross-
Connection Control Plans ("CCCP's"to comply with the standards and procedures outlined in
the Handbook, including provisions for hazard classification, backflow prevention, inspections,
enforcement, and incident response; and
WHEREAS,staff has reviewed the requirements of the Handbook and prepared a Cross-
Connection Control Plan for the City of Rohnert Park that aligns with State regulations and
ensures the continued protection of the public water supply; and
WHEREAS, adoption of the City's Cross-Connection Control Plan reflects the City of
Rohnert Park's commitment to public health, regulatory compliance, and water quality
protection.
NOW,THEREFORE,BE IT RESOLVED by the City Council of the City of Rohnert
Park that it does hereby adopt the Cross-Connection Control Plan, attached as Exhibit A, in
accordance with the California State Water Resources Control Board Cross-Connection Control
Policy Handbook, as written in Exhibit A and subject to minor edits.
BE IT FURTHER RESOLVED that the City Manager or designee is hereby authorized
and directed to execute documents pertaining to same for and on behalf of the City of Rohnert
Park.
DULY AND REGULARLY ADOPTED BY THE CITY COUNCIL OF THE CITY
OF ROHNERT PARK ON this 10th day of June 2025.
CITY R h 'ERT PARK
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Attachments: Exhibit A
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Resolution 2025-038
Page 2 of 2
Prepared for:
City of Rohnert Park
600 Enterprise Dr
Rohnert Park, CA 94928
CROSS CONNECTION CONTROL PLAN
For
City of Rohnert Park
City of Rohnert Park
Approved: 4/24/2025
Prepared by:
5700 Crooks Rd., Suite 100
Troy, MI 48098
Phone: 248.250.5000
EXHIBIT A
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TABLE OF CONTENTS
1. INTRODUCTION ................................................................................................................................ 1
1.1. Applicability ........................................................................................................................ 1
1.2. California Safe Drinking Water Act ..................................................................................... 1
1.3. The California EPA’s Cross Connection Control Policy Handbook Adoption ...................... 2
1.4. Legal Authority .................................................................................................................... 2
2. BACKFLOW PROTECTION AND CROSS-CONNECTION CONTROL ..................................................... 3
2.1. Definitions ........................................................................................................................... 4
3. PROGRAM APPROACH ..................................................................................................................... 7
3.1. Initial Hazard Assessment ................................................................................................... 7
3.2. Ongoing Hazard Assessment .............................................................................................. 8
4 APPLICATION OF BACKFLOW PREVENTERS ..................................................................................... 9
4.1 Backflow Protection Table .................................................................................................. 9
4.2 Standards for Types of Backflow Protection ....................................................................... 9
4.3 Installation Criteria for Backflow Protection .................................................................... 10
4.4 Fire Protection System Cross-Connection Control Requirements .................................... 10
5 TESTING BACKFLOW PREVENTION ASSEMBLIES............................................................................ 12
6 Backflow Prevention Assembly Testers and Cross Connection Specialist ..................................... 14
6.1 Process for Ensuring Qualifications .................................................................................. 14
7 RECORD KEEPING ........................................................................................................................... 15
8 ENFORCEMENT .............................................................................................................................. 17
9 PUBLIC EDUCATION ....................................................................................................................... 18
10 BACKFLOW INCIDENT RESPONSE PLAN ......................................................................................... 19
10.1 Incident Identification and Initial Response ..................................................................... 19
10.2 Investigation and Verification ........................................................................................... 19
10.3 Response and Follow-Up Actions ..................................................................................... 20
APPENDIX A - ASME A112.1.2-2012(R2017) ............................................................................................. XXII
APPENDIX B - HIGH HAZARD CROSS-CONNECTION CONTROL PREMISES ............................................... XXIII
APPENDIX C – RELATED STATUTES AND REGULATIONS ........................................................................... XXV
APPENDIX D – SAMPLE BACKFLOW INCIDENT RESPONSE FORM ............................................................ XXIX
APPENDIX E – ORDINANCE ....................................................................................................................... XXXI
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1. INTRODUCTION
The Cross-Connection Control Plan for the City of Rohnert Park Water Division is designed to
protect the public water system from contamination and pollution caused by backflow incidents.
This plan is meticulously aligned with the guidelines and requirements outlined in the State Water
Resources Control Board (SWRCB) "Cross-Connection Control Policy Handbook," which became
effective on July 1, 2024. Our objective is to ensure that the potable water supply remains safe
and secure by preventing any possible cross-connections that could lead to backflow into the
water distribution system.
The purpose of this document is to outline the City of Rohnert Park’s Cross Connection Control
policies for all non-residential, institutional, industrial, residential and miscellaneous water
customers, and are summarized as follows:
• Protect the public water system from contaminants and/or pollutants that could
backflow through the customer service connection.
• Promote the elimination of actual and/or potential cross-connections between the
public potable water system and non-potable water systems, plumbing fixtures, sources
and/or systems containing substances of unknown or questionable quality.
• Provide guidance for the maintenance of a continuing Cross Connection Control
program.
1.1. Applicability
In accordance with CA-EPA-CCCPH Standards and Principles for California’s Public Water Systems
as defined in California Health and Safety Code (CHSC section 116275 (h)). Compliance with the
CA-EPA-CCCPH is mandatory for the City of Rohnert Park.
Prior to the CA-EPA-CCCPH, the City of Rohnert Park conformed to the standards established by
the American Water Works Association (AWWA), as set forth in its publication entitled:
AWWA.C506-78 Standards for Reduced Pressure Principle, and Double Check backflow
prevention devices. A “Certificate of Approval” issued by an approved testing laboratory,
certifying full compliance with AWWA Standards.
1.2. California Safe Drinking Water Act
In 2014, the State Water Resources Control Board assumed responsibility for the drinking water,
and financial programs throughout the State, prior to that it was CA-DHS. On October 6, 2017,
Assembly Bill 1671 (AB 1671) was approved and filed with the Secretary of State (see Appendix
A). AB 1671 amended California’s SDWA through the establishment of CHSC sections 116407 and
116555.5. AB 1671 also amended section 116810 of the CHSC, which is briefly discussed in
Appendix C.
On October 2nd, 2019, Assembly Bill 1180 (AB 1180) was approved and filed with the Secretary
of State. AB 1180 Amended Section 116407 of the CHSC and added section 13521.1 to the water
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code. AB 1180 requires that the CA-EPA-CCCPH include provisions of the swivel or change over
device (swivel-ell).
1.3. The California EPA’s Cross Connection Control Policy Handbook Adoption
The California Environmental Protection Agency completed development of the Cross Connection
Control Policy Handbook for standards and principles for California’s Public Water Systems. In this
document for the City of Rohnert Park, it will be referred to as the CA-EPA-CCCPH. The State Water
Resources Control Board adopted the CA-EPA-CCCPH on December 19th, 2023, and went into
effect on July 1st, 2024. Upon the effective date of the CA-EPA-CCCPH.
A PWS must implement a cross-connection control program that complies with the standards
adopted by the State Water Board. The development of the CA-EPA-CCCPH included consultation
with stakeholders, including state and local agencies, on an array of subjects related to cross-
connection control, consistent with the statutory mandate, as well as consideration of input from
other stakeholders and the general public in a February 20, 2020, workshop.
1.4. Legal Authority
The City of Rohnert Park has operating rules, By-laws, and regulations established for
enforcement throughout the distribution system. These rules and regulations are documented in
the City of Rohnert Park’s Code of Ordinances Title 13 Chapter 13.04 Cross Connection
Regulations.
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2. BACKFLOW PROTECTION AND CROSS-CONNECTION CONTROL
A cross-connection is an interconnection between a potable water supply and a non-potable source
via any actual or potential connection or structural arrangement between a PWS and any source or
distribution system containing liquid, gas, or other substances not from an approved water supply.
Bypass arrangements, jumper connections, removable sections, improperly installed swivel, or
change-over devices and other temporary or permanent devices through which, or because of which
backflow can occur are cross-connections. The CA-EPA-CCCPH includes acceptable installation criteria
for swivel-ell and other types of backflow prevention assemblies (BPAs) to prevent backflow.
Backflow is the undesired or unintended reversal of flow of water and/or other liquids, gases, or other
substances into PWS’s distribution system or approved water supply. The presence of a cross-
connection represents a location in a distribution system through which backflow of contaminants or
pollutants can occur. Backflow occurs when a non-potable source is at a greater pressure than the
potable water distribution system. Backflow can occur from either back-siphonage or backpressure.
Back-siphonage occurs when a non-potable source enters the drinking water supply due to negative
(i.e., sub-atmospheric) distribution system pressure. Backpressure occurs when the pressure from a
non-potable source exceeds the pressure in the potable water distribution system.
Back-siphonage may be caused by a variety of circumstances, such as main breaks, flushing, pump
failure, or emergency firefighting water demand. Backpressure may occur when heating, cooling,
waste disposal, or industrial manufacturing systems are connected to potable supplies and the
pressure in the external system exceeds the pressure in the distribution system. Both situations act
to change the direction of water, which normally flows from the distribution system to the customer,
so that non-potable substances from industrial, commercial, or residential premises flows back into
the distribution system through a cross-connection.
Cross-connections are not limited to industrial or commercial facilities. Submerged inlets are found
on many common plumbing fixtures and are sometimes necessary features of the fixtures if they are
to function properly. Examples of this type of design are siphon-jet urinals or water closets, flushing
rim slop sinks, and dental cuspidors.
Older bathtubs and lavatories may have supply inlets below the flood level rims, but modern sanitary
design has minimized or eliminated this cross-connection in new fixtures. Chemical and industrial
process vats sometimes have submerged inlets where the water pressure is used as an aid in diffusion,
dispersion, and agitation of the vat contents. Even though a supply pipe may be installed above a vat,
back-siphonage can still occur. Siphon action has been shown to raise a liquid in a pipe such as water
almost 34 feet. Some submerged inlets are difficult to control, including those which are not apparent
until a significant change in water level occurs or where a supply may be conveniently extended below
the liquid surface by means of a hose or auxiliary piping. A submerged inlet may be created in
numerous ways, and its detection may be difficult.
Chemical and biological contaminants have caused illness and deaths during known incidents of
backflow, with contamination affecting several service connections, and the number of incidents
reported is believed to be a small percentage of the total number of backflow incidents that occur.
The public health risk from cross-connections and backflow is a function of a variety of factors
including cross-connection and backflow occurrence and type and number of contaminants.
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2.1. Definitions
“Air-gap separation” or “AG” means a physical vertical separation of at least two (2) times the
effective pipe diameter between the free-flowing discharge end of a potable water supply
pipeline and the flood level of an open or non-pressurized receiving vessel, and in no case less
than one (1) inch.
“AMI” means automated meter infrastructure. Smart Meter, Electronic Meter
“Approved water supply” means a water source that has been approved by the State Water
Board for domestic use in a public water system and designated as such in a domestic water
supply permit issued pursuant to section 116525 of the CHSC.
“Auxiliary water supply” means a source of water, other than an approved water supply, that is
either used or equipped, or can be equipped, to be used as a water supply and is located on the
premises of, or available to, a water user.
“Backflow” means an undesired or unintended reversal of flow of water and/or other liquids,
gases, or other substances into a public water system’s distribution system or approved water
supply.
“Backflow prevention assembly” or “BPA” means a mechanical assembly designed and
constructed to prevent backflow, such that while in-line it can be maintained and its ability to
prevent backflow, as designed, can be field tested, inspected and evaluated.
“Backflow prevention assembly tester” means a person who is certified as a backflow prevention
assembly tester.
“BPA” means Backflow Prevention Assembly.
“Community water system” means a public water system that serves at least 15 service
connections used by yearlong residents or regularly serves at least 25 year-long residents of the
area served by the system.
“CA-EPA-CCCPH” means California Cross Connection Control Handbook
“Cross-connection” means any actual or potential connection or structural arrangement between
a public water system, including a piping system connected to the public water system located on
the premises of a water user or available to the water user, and any source or distribution system
containing liquid, gas, or other substances not from an approved water supply.
“Cross-connection control specialist” means a person who is certified as a cross-connection
control specialist.
“District Boundary” Is a boundary established by a local agency formation commission or
organization, established within the county where services are served, and may not serve outside
the District Boundary.
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“Distribution system” has the same meaning as defined in section 63750.50 of CCR, Title 22,
Division 4, Chapter 2.
“Double check detector backflow prevention assembly” or “DCDA” means a double check valve
backflow prevention assembly that includes a bypass with a water meter and double check
backflow prevention assembly, with the bypass’s water meter accurately registering flow rates up
to two gallons per minute and visually showing a registration for all rates of flow. This type of
assembly may only be used to isolate low hazard cross-connections.
“Double check valve backflow prevention assembly” or “DC” means an assembly consisting of
two independently acting internally loaded check valves, with tightly closing shut-off valves
located at each end of the assembly (upstream and downstream of the two check valves) and
fitted with test cocks that enable accurate field testing of the assembly. This type of assembly may
only be used to isolate low hazard cross-connections.
“Existing public water system” or “existing PWS” means a public water system initially permitted
on or before July 1, 2024, as a public water system by the State Water Board.
“Hazard Assessment” means an evaluation of a user premises designed to evaluate the types and
degrees of hazard at a user’s premises.
“High hazard cross-connection” means a cross-connection that poses a threat to the potability or
safety of the public water supply. Materials entering the public water supply through a high
hazard cross-connection are contaminants or health hazards.
“Low hazard cross-connection” means a cross-connection that has been found to not pose a
threat to the potability or safety of the public water supply but may adversely affect the aesthetic
quality of the potable water supply. Materials entering the public water supply through a low
hazard cross-connection are pollutants or non-health hazards.
“PWS” means Public Water Supply.
“Reduced Pressure Principle Backflow Prevention Assembly” or “RP” means an assembly with
two independently acting internally-loaded check valves, with a hydraulically operating
mechanically independent differential-pressure relief valve located between the check valves and
below the upstream check valve. The assembly shall have shut-off valves located upstream and
downstream of the two check-valves, and test cocks to enable accurate field testing of the
assembly.
“Reduced pressure principle detector backflow prevention assembly” or “RPDA” means a
reduced pressure principle backflow prevention assembly that includes a bypass with a water
meter and reduced pressure principle backflow. prevention assembly, with the bypass’s water
meter accurately registering flow rates up to two gallons per minute and visually showing a
registration for all rates of flow.
“State Water Board”, unless otherwise specified, means the State Water Resources Control Board
or the local primacy agency having been delegated the authority to enforce the requirements of
the CCCPH by the State Water Resources Control Board.
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“Swivel-Ell” means a reduced pressure principle backflow prevention assembly combined with a
changeover piping configuration (swivel-ell connection) designed and constructed for recycled
water/non-potable switchover situations within a Services District.
“User premises” means the property under the ownership or control of a water user and is served,
or is readily capable of being served, with water via a service connection with a public water
system.
“User’s service connection” means either the point where a water user’s piping is connected to
a water system or the point in a water system where the approved water supply can be protected
from backflow using an air gap or backflow prevention assembly.
“User Supervisor” means a person designated by a water user to oversee a water use site and
responsible for the avoidance of cross-connections.
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3. PROGRAM APPROACH
The process for conducting initial and ongoing hazard assessments under the CCCPH involves a
structured approach to identifying potential cross-connection risks and implementing the necessary
protective measures. This process ensures the safety and integrity of the water distribution system
by evaluating all existing and proposed water service connections for potential contamination
hazards.
The water connections and plumbing systems of all service connections or accounts shall be initially
assessed for the presence of cross-connections. As a result of the initial assessment, a detailed record
of each account shall be established. A certified AWWA Cross-Connection Control Specialist shall be
responsible for assessments. Individuals responsible for conducting inspections shall have obtained
sufficient training on cross-connection rules, identification, and corrective actions.
The highest priority for assessments shall be placed on facilities that pose a high degree of hazard,
that have a high probability that backflow will occur, or have the potential for cross-connections.
Once initial assessments are complete then an assessment frequency shall be determined for each
account based on the degree of hazard and potential for backflow. The AWWA M14 Cross Connection
Rules Manual will be a guide in classifying the degree of hazard of each account. However, in general,
situations in which backflow could cause illness or death shall be considered high hazard. Other
factors such as new construction, water quality complaints, or anomalies in customer billing, may
prompt an immediate re-inspection. After initial cross-connection assessments are complete, a
comprehensive list or inventory of all backflow prevention assemblies, methods and devices shall be
on record including all pertinent data.
3.1. Initial Hazard Assessment
All new water service connections must undergo an initial assessment before activation. Existing
connections shall be assessed in accordance with the City of Rohnert Park’s cross-connection
control program timeline. Commercial, industrial, public authority, and other potential high-
hazard facilities that have not received an initial hazard assessment will be surveyed within seven
years of this plan's acceptance. Residential and multifamily facilities without a prior assessment
will be surveyed within fifteen years of the plan's adoption.
To evaluate the potential risk of backflow into the public water system, the City of Rohnert Park
will carry out an initial hazard assessment of user premises within its service area. This hazard
evaluation will take into account the following considerations as necessary:
a) The presence of cross-connections;
b) the types of materials handled or present on the premises, including those likely to be
encountered;
c) the complexity and accessibility of the piping system;
d) access to auxiliary water supplies, pumping systems, or pressure systems;
e) conditions within the distribution system that may increase the likelihood of a backflow
event, such as hydraulic gradient differences caused by main breaks, high water demand,
or multiple service connections that could lead to flow-through conditions;
f) accessibility of the premises;
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g) any history of backflow incidents on the premises or similar sites; and
h) the requirements and guidance provided in the CCCPH.
Each hazard assessment must classify the level of risk to the distribution system as a high-hazard
cross-connection, a low-hazard cross-connection. Examples of high-hazard cross-connection
activities can be found in Appendix B.
• The hazard assessment must determine whether an existing backflow prevention
assembly (if any) provides adequate protection based on the degree of hazard.
3.2. Ongoing Hazard Assessment
Ongoing or follow-up hazard assessments are required following the initial hazard assessment
described in Section 3.1. A follow-up hazard assessment will be conducted under the following
circumstances:
a) if a user premises changes ownership, excluding single-family residences;
b) if a user premises is newly connected to the PWS;
c) if evidence exists of potential changes in the activities or materials on a user’s premises.
d) if backflow from a user’s premises occurs;
e) periodically, as identified in the Cross-Connection Control Plan
f) if the State Water Board requests a hazard assessment of a user’s premises; and
g) if the PWS concludes an existing hazard assessment may no longer be correct.
The City of Rohnert Park must ensure a certified AWWA cross-connection control specialist reviews
the hazard assessments and makes a written finding that, in their judgment based on cross-
connection control principles, the hazard assessment properly identified all hazards, the appropriate
degree of hazards, and the corresponding backflow protection.
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4 APPLICATION OF BACKFLOW PREVENTERS
4.1 Backflow Protection Table
The following table outlines acceptable backflow protection for certain types of cross-connection
conditions that may be encountered. The table is to be used as a guideline in determining adequate
cross-connection control measures, not as an absolute requirement.
Backflow Preventer
Type
Degree of Hazard Application Applicable Standard
Backflow prevention assemblies:
Double Check Valve
Assembly (DCV)
Low hazard Backpressure or
backsiphonage
ASSE 1015, AWWA C510,
CSA B64.5, CSA B64.5.1
Double Check Detector
Assembly (DCDA)Type I & II
Low hazard Backpressure or
backsiphonage
ASSE 1048
Pressure Vacuum Breaker
Assembly (PVB)
High or low hazard Backsiphonage ASSE 1020, CSA B64.1.2
Reduced Pressure Principle
Backflow Prevention
Assembly (RP)
High or low hazard Backpressure or
backsiphonage
ASSE 1013, AWWA C5411,
CSA B64.4, CSA B64.4.1
Reduced Pressure Detector
Assembly (RPDA) Type I & II
High or low hazard Backpressure or
backsiphonage
ASSE 1047
Spill-resistant Vacuum
Breaker Assembly (SVB)
High or low hazard Backsiphonage ASSE 1056
Backflow prevention method:
Air Gap (AG) High or low hazard Backsiphonage ASME A112.1.2
4.2 Standards for Types of Backflow Protection
a) AG’s must meet the requirements in section 603.3.1 of the 2019 California Plumbing Code
(See Appendix A).
b) Newly installed pressure vacuum breaker, DCVs, and RPs for protection of the PWS is
approved through both laboratory and field evaluation tests performed in accordance with
either:
i. Standards found in the 10th edition of the Foundation for Cross-Connection Control
and Hydraulic Research of the University of Southern California Manual of Cross-
Connection Control;
ii. certification requirements for backflow prevention assemblies in the Standards of
ASSE International current as of 2020; or
iii. a testing process with equivalent testing requirements to (1) or (2).
c) Backflow prevention assemblies must not be modified from the approval granted in CCCPH
section 3.3.1 (b). The City of Rohnert Park will require backflow prevention assembly testers
to notify the City’s Cross-Connection Specialist if a water user or utility-owned backflow
prevention assembly has been modified from section 4.2 b) approval.
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4.3 Installation Criteria for Backflow Protection
a) For AGs, the following is required:
i. The receiving water container must be located on the water user’s premises at the
water user’s service connection unless an alternate location has been approved by
the City of Rohnert Park.
ii. all piping between the water user’s service connection and the discharge location of
the receiving water container must be above finished grade and be accessible for
visual inspection unless an alternative piping configuration is approved by the City of
Rohnert Park.
iii. the City of Rohnert Park will ensure that the AG specified in section 4.1 a) has been
installed; and
iv. any new air gap installation at a user service connection must be reviewed and
approved by the State Water Board prior to installation.
b) A RP must be installed such that the lowest point of the assembly is a minimum of twelve
inches and, unless an alternative is approved by the City of Rohnert Park’s Cross-Connection
Specialist, a maximum of thirty- six inches above the finished grade.
c) DCs installed or replaced after the adoption of the CCCPH must be installed according to
section 4.3 ii. Below ground installation can be considered by the Rohnert Park Water
Department if it determines no alternative options are available.
d) A PVB or SVB must be installed a minimum of twelve inches above all downstream piping.
e) PVBs and SVBs may not be used for premises isolation.
f) A RP or DCV installed after the adoption of the CCCPH must have a minimum side clearance
of twelve inches, except that a minimum side clearance of twenty-four inches must be
provided on the side of the assembly that contains the test cocks.
g) Backflow protection must be located at the water user’s service connection unless one or
more alternative locations have been approved by the Cross-Connection Specialist. If internal
protection is provided the City of Rohnert Park or designated agent must obtain access to the
user premises and must ensure that the on-site protection meets the requirements of this
Chapter for installation, testing and inspections.
h) Each backflow prevention assembly and air gap separation must be accessible for field testing
and maintenance.
4.4 Fire Protection System Cross-Connection Control Requirements
Except as noted below, City of Rohnert Park must ensure that its distribution system is protected
with no less than Double Check (DC) protection for a user premises with a fire protection system
within twenty years of the adoption of the Cross-Connection Control Policy Handbook (CCCPH).
a) A high-hazard cross-connection fire protection system—including, but not limited to, systems
that may utilize chemical additives (e.g., wetting agents, foam, anti-freeze, corrosion
inhibitors) or an auxiliary water supply—must have no less than Reduced Pressure (RP)
protection.
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b) If an existing fire protection system cannot install DC protection within twenty years of CCCPH
adoption, the City of Rohnert Park may propose an alternative method of backflow protection
that provides an equivalent level of public health protection.
c) Backflow Prevention Assembly (BPA) is not required for a low-hazard fire protection system
on a residential user premises if all of the following criteria are met:
i. The user premises has only one service connection to the PWS.
ii. A single service line enters the premises and then splits on the property for both
domestic and fire protection system flow, allowing the fire protection system to be
isolated from the rest of the premises.
iii. A single, industry-standard water meter measures combined domestic and fire
protection system flow.
iv. The fire protection system is constructed of piping materials certified to meet
NSF/ANSI Standard 61.
v. The fire protection system’s piping is looped within the structure and connected to
one or more routinely used fixtures (e.g., a water closet) to prevent stagnant water.
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5 TESTING BACKFLOW PREVENTION ASSEMBLIES
When assessments have been completed, a comprehensive list of backflow preventers installed on
customer plumbing systems will be on record. The backflow preventers that are testable assemblies
shall be placed on a routine testing schedule. All testable assemblies will be tested upon installation,
upon repair and on an annual basis.
Upon notice from the City, the water customer shall be responsible to arrange and absorb any costs
associated with assembly testing and subsequent repair/replacement of backflow prevention
assemblies.
Following the initial cross-connection assessments and the subsequent classification of accounts (e.g.,
assigning a degree of hazard), assembly testing notices shall be sent annually to both non-residential
and residential water customers. Customers will have thirty (30) days from the date of the notice to
complete the required testing.
If the City does not receive a completed test report within the initial 30-day period, a second notice
will be issued, allowing 15 additional days for compliance. If necessary, a third notice will follow,
providing a final 5-day compliance period. Failure to submit a completed test report after the 5 days
may result in the discontinuation of water service to the premises.
The notices will:
• Clearly identify the assembly requiring testing (size, make, model, location, etc.)
• Stipulate the date by which the assembly must be tested.
• Indicate that tests must be completed by a certified tester.
• a list of testable backflow prevention assemblies on the premises.
When assembly testing reports are received by the utility, they will be checked for the following:
• All the necessary information was provided.
• Name and certification number of the tester is provided.
• The test results appear valid.
• The assembly tested matches the assembly requiring testing (Make, Model, etc.).
• The assembly is approved.
• A backflow tester found falsifying test results or not meeting the City of Rohnert Park’s
performance standards will be removed from the approved tester list and may be subject to
additional regulatory action.
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Test results are only valid if testing was performed by an individual holding an active certification from
an organization recognized by the State Water Board, see section 6.
a) Backflow Prevention Assembly Test Result Reports:
i. Accurate and Timely Reporting: Every test conducted on a backflow prevention
assembly must be documented in a format approved by the City. These reports detail
the condition of the assembly, test results, and any repairs or replacements made.
The water utility must ensure that testers are submitting accurate and complete
reports after each test.
ii. Review and Verification of Reports: The utility shall review all test result reports for
completeness and accuracy. This includes confirming that all fields are correctly filled
out, that the results align with acceptable performance standards, and that any failed
tests are followed up with repairs and retesting.
iii. Archiving Reports: All test result reports must be archived for regulatory compliance
purposes. The utility will have a system for tracking and storing reports, ensuring they
are readily available for review by regulatory authorities. These records are essential
for demonstrating compliance with the state’s cross-connection control
requirements.
• Backflow prevention assemblies that fail the field test are required to be immediately
reported to the City. The failed device is required to be repaired, replaced, and re-tested
within 30 days.
• Backflow prevention assembly testers is required to notify the City’s Cross-Connection
Specialist within one day if a backflow incident or cross-connection is observed during
testing.
Air-gap separations installed pursuant to sections 4.2 and 4.3 must be visually inspected at least
annually to determine compliance with this Chapter by persons certified as backflow preventer
assembly testers or certified as a cross- connection control specialist pursuant to Section 6.
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6 Backflow Prevention Assembly Testers and Cross Connection Specialist
To comply with the California Cross-Connection Control Policy Handbook, it is essential that all
individuals responsible for testing, inspecting, and maintaining backflow prevention assemblies meet
the necessary qualifications and certifications. This process ensures that the water distribution system
is safeguarded from contamination risks by having only competent, certified professionals handle
backflow prevention assemblies. Key elements of this process include verifying the individual’s
certification, ensuring the calibration of test equipment, and maintaining accurate reports of test
results.
a) Certified Backflow Prevention Assembly Testers and Certified Cross-Connection Control
Specialists – The City of Rohnert Park must ensure all backflow prevention assembly testers
and cross-connection control specialists used are certified per Article 4 of the SWRCB CCCPH
6.1 Process for Ensuring Qualifications
a) Verification of Certification as a Backflow Prevention Assembly Tester:
i. Certification Requirements: Every individual performing testing or inspections on
backflow prevention assemblies must be a certified Backflow Prevention Assembly
Tester, as defined by the SWRCB CCCPH. Certification typically requires passing a
written and practical examination administered by a state-approved certification
agency.
ii. Initial Verification: Before authorizing a tester to conduct work within the water
system, the water utility must confirm the individual holds a valid certification. This is
typically done by requesting a copy of the tester’s certification and checking it against
a list of approved certification agencies.
iii. Ongoing Compliance: The utility must regularly verify that the tester’s certification
remains current. Certification usually requires periodic renewal, which may include
continuing education or retesting. A record of certification status should be
maintained for each tester authorized to work within the City’s service area.
b) Test Kit Calibration:
i. Calibration Requirements: To ensure the accuracy of backflow prevention assembly
testing, testers must use calibrated testing equipment. Test kits must be calibrated
at least annually or more frequently if recommended by the manufacturer.
ii. Verification of Calibration: Before permitting a tester to perform inspections or
testing, the utility must verify that their test kit has been calibrated within the
required timeframe. This can be done by reviewing a calibration certificate from an
accredited calibration facility or manufacturer.
iii. Ongoing Monitoring: The utility should maintain a schedule of calibration due dates
for each tester’s equipment and require updated calibration certificates as a
condition for continued work. Uncalibrated equipment should not be allowed for
testing until calibration is confirmed.
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7 RECORD KEEPING
A robust tracking system is essential for managing and maintaining compliance with the California
Cross-Connection Control Policy Handbook (CCCPH). This system ensures that all relevant
information about backflow prevention assemblies is readily available, up-to-date, and meets the
recordkeeping requirements outlined in the CCCPH. The system is designed to track vital details,
including recordkeeping information, the location and type of backflow prevention assemblies,
and the specific hazards each assembly protects against.
A system of cross-connection record keeping shall be maintained. Special software specifically for
cross-connections may be used for:
• Efficient record searches
• Easy reporting
• Simple updating
• Automatic letter generation
• Automatic deadline notification
All hazard assessment information must be in the records including:
• Address and location
• Owner name and contact information
• List of testable assemblies
• Description of other cross-connections within the facility
- Air gaps
- Non-testable assemblies
• Degree of hazard classification and basis
• Required re-inspection frequency
All testable assemblies must be in the records including:
• Location of the assembly
• Name and contact information of assembly owner
• Make, model, and size of assembly
• Degree of hazard classification
• Required testing frequency and basis
• Test history
Standard letter, form, and report templates may be used to simplify the program requirements
including:
• Inspection forms
• Assembly testing forms
• Inspection and/or assembly testing notification letters
• Noncompliance letters
• Water service termination notice
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Monitoring changes in water usage and identifying new customers are essential aspects of the
cross-connection control program. The City of Rohnert Park will make every effort to prevent and
eliminate cross-connections during installations to ensure ongoing compliance. Collaboration and
communication with the City’s building department will be prioritized to support this objective.
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8 ENFORCEMENT
To safeguard public health, water customers found in violation of cross-connection regulations
will be required to comply promptly or risk having their connection to the public water system
terminated. The City of Rohnert Park’s ordinance grants authority to inspect facilities, terminate
water service, and impose fines to enforce these rules.
Following an inspection, if a violation is identified, the customer will be issued a non-compliance
notice. The timeframe for completing corrective actions will be determined by the City’s Cross-
Connection Specialist, based primarily on the severity of the risk posed by the violation, but also
considering the complexity and cost of the required actions. Cross-connections that present an
imminent and extreme hazard will be immediately disconnected and remain so until pro per
protection is installed. Less severe cross-connections are generally expected to be resolved within
30 to 60 days. The specific corrective actions and deadlines will be outlined in the non-compliance
notice.
Failure to submit a test form for a backflow prevention assembly that has passed testing
requirements is considered a cross-connection violation and must be corrected. Non-compliance
may result in water service termination.
In cases where water service must be shut off to protect the public water system, the SWRCB,
Utility Billing Dept, Utilities Manager, and Public Works Director need to be notified.
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9 PUBLIC EDUCATION
The cross-connection control program staff must have a good understanding of the program. The City
staff shall ensure their cross-connection control staff receives proper in-the-field training as well as
classroom education focusing on terminology, backflow prevention devices/assemblies, regulations,
and hydraulic concepts. In addition, cross-connection control staff will be encouraged to receive
continuing education to be made aware of new backflow prevention devices/assemblies, regulation
changes (i.e. plumbing code updates), new water use devices that pose cross-connection concerns,
etc.
Furthermore, attempts to educate the public about cross-connections may be made by distributing
information either by UB mailing, social media, or other platforms on common residential cross-
connections, providing onsite education of facility management and maintenance staff during routine
inspections.
The public outreach and education program is designed to raise awareness about the importance of
cross-connection control and the potential risks associated with backflow. The program aims to
inform and educate property owners, businesses, and the general public about their responsibilities
in preventing cross-connections and ensuring the safety of the public drinking water system.
Target Audience:
• Property owners
• Businesses
• Building officials
• Plumbing officials
• General public
Key Components:
• Educational Materials:
o Develop informative materials such as brochures, flyers, posters, and fact sheets that
explain the concept of cross-connections, the potential risks, and the importance of
backflow prevention.
o Include clear and concise information about the requirements of the CCCPH and the
role of property owners and businesses in preventing cross-connections.
• Online Resources:
o Develop a dedicated website or online portal with resources related to cross-
connection control, including educational materials, FAQs, and contact information.
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10 BACKFLOW INCIDENT RESPONSE PLAN
The City shall develop and maintain an Emergency Response Plan document to appropriately respond
to a backflow event. The written ERP shall be readily available to designated personnel. This
procedure outlines the process for investigating and responding to suspected backflow incidents to
safeguard public health and ensure the safety and quality of the water supply. It addresses steps from
initial reporting through investigation, corrective actions, and follow-up. A sample incident response
can be found in Appendix D.
10.1 Incident Identification and Initial Response
Consideration of Complaints or Reports of Changes in Water Quality as Possible Backflow
Incidents.
• When a complaint or report of a change in water quality is received, further investigation
may be conducted by the City’s Cross-Connection Specialist to determine if a potential
backflow incident may have occurred. Common complaints that could indicate backflow
include:
o Unusual taste, odor, or color in water
o Visible debris or particles in water
o Reports of illness that could be linked to water quality
o Changes in water pressure or flow
Initial Response:
• Customer Interview: Contact the customer to gather detailed information about the
complaint (e.g., location, time, and description of the issue).
• Dispatch Team: Send a field technician to the reported location for an initial assessment
and water quality sampling.
10.2 Investigation and Verification
Water Quality Sampling and Pressure Recording.
• Once a suspected backflow incident is reported, a thorough investigation will be
initiated, involving both water quality testing and pressure monitoring.
Steps:
1. Water Quality Sampling
o On-Site Testing: Field personnel will conduct immediate water quality tests at
the site of the reported incident, which may include testing for parameters such
as:
▪ Chlorine residual
▪ pH
▪ Turbidity
▪ Presence of bacteria or contaminants
o Laboratory Analysis: If required, water samples will be sent to a certified
laboratory for more comprehensive testing, including testing for chemicals,
pollutants, or pathogens that may indicate contamination from backflow.
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2. Pressure Recording
o System Pressure Evaluation: Review pressure data from the local area, focusing
on any recent drops in system pressure that could indicate a backflow event.
Field technicians may also install temporary pressure loggers in the affected area
to monitor any ongoing pressure fluctuations.
3. Cross-Connection Inspection
o Perform a survey of the suspected location and surrounding areas to identify
potential cross-connections that could have led to backflow. Verify that these
connections are properly protected by backflow prevention
assembly(s)/devices.
10.3 Response and Follow-Up Actions
Documentation of the Investigation, Response, and Follow-Up Activities.
• Every step of the investigation, response, and follow-up will be documented to ensure a
clear record of actions taken and to maintain compliance with regulatory requirements.
Steps:
1. Incident Report
o Details of the Report: The utility will create a formal report documenting the
nature of the complaint, location, time of the report, and the suspected cause
of the backflow incident.
o Investigation Summary: The report will include details of the investigation, such
as:
▪ Results of water quality testing
▪ Pressure monitoring data
▪ Findings from cross-connection inspections
▪ Condition of backflow prevention devices
2. Corrective Actions
o Immediate Actions: If backflow is confirmed, the utility will isolate the affected
area, notify customers, and initiate system flushing and disinfection procedures.
o Repair or Replacement: Backflow prevention devices that are malfunctioning or
improperly installed will be repaired or replaced. Any identified cross-
connections will be corrected.
o Customer Notification: Affected customers will be informed of the findings and
the steps taken to restore safe water quality.
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3. Follow-Up Activities
o Continued Monitoring: After the incident has been resolved, water quality in the
affected area will continue to be monitored to ensure no further issues occur.
o Regulatory Reporting: A formal report will be submitted to the State Water
Resources Control Board or other relevant regulatory bodies, detailing the
incident and corrective measures taken.
4. Recordkeeping and Review
o Documentation Retention: All documentation, including the incident report, test
results, and corrective action logs, will be stored in the utility’s records
management system for future reference and auditing.
o Incident Review: The utility will conduct an internal review to assess whether any
changes are needed in cross-connection control measures or backflow
prevention device maintenance practices.
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APPENDIX A - ASME A112.1.2-2012(R2017)
Table 1, Minimum Air Gaps for Generally used Plumbing Fixtures,1 page 4
TABLE 1
Minimum Air Gaps for Generally used
Plumbing Fixtures4
FIXTURES WHERE NOT AFFECTED
BY SIDEWALLS1
(inches)
WHERE AFFECTED BY
SIDEWALLS2
(inches)
Effective opening3 not
greater than ½ of an inch
in diameter
1 11/2
Effective openings3 not
greater than ¾ of an inch
in diameter
11/2 21/4
Effective openings3 not
greater than 1 inch in
diameter
2 3
Effective openings3
greater than 1 inch in
diameter
Two times the diameter of
effective opening
Three times the diameter of
effective opening
For SI units: 1 inch = 25.4 mm
Notes:
1 Sidewalls, ribs, or similar obstructions do not affect air gaps where spaced from
the inside edge of the spout opening at a distance exceeding three times the diameter
of the effective opening for a single wall, or at a distance exceeding four times the
effective opening for two intersecting walls.
2 Vertical walls, ribs, or similar obstructions extending from the water surface to or
above the horizontal plane of the spout opening other than specified in Footnote 1
above. The effect of three or more such vertical walls or ribs has not been
determined. In such cases, the air gap shall be measured from the top of the wall.
3 The effective opening shall be the minimum cross-sectional area at the seat of the
control valve or the supply pipe or tubing that feeds the device or outlet. Where two
or more lines supply one outlet, the effective opening shall be the sum of the cross-
sectional areas of the individual supply lines or the area of the single outlet,
whichever is smaller.
4 Air gaps less than 1 inch (25.4 mm) shall be approved as a permanent part of a
listed assembly that has been tested under actual backflow conditions with vacuums
of 0 to 25 inches of mercury (85 kPa).
1 Reprinted from ASME A112.1.2-2012(R2017), by permission of The American Society of Mechanical
Engineers. All rights reserved
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APPENDIX B - HIGH HAZARD CROSS-CONNECTION CONTROL PREMISES
The list below identifies premises that require backflow protection provided by an air gap or a reduced
pressure principle backflow prevention assembly, unless noted otherwise. The list below is not
intended to be all-inclusive. A PWS, State Water Board, or local health agency may require an AG, RP,
or both to protect a PWS from other hazards not listed below and identified in premises through the
hazard assessment completed in CCCPH section 3.1. A PWS may reduce or increase the minimum
protection required for a previously hazard-assessed user premise following a hazard reassessment
as described in CCCPH section 3.1.
1. Sewage handling facilities
2. Wastewater lift stations and pumping stations
3. Wastewater treatment processes, handling, or pumping equipment that is interconnected to a
piping system connected to a PWS (+)
4. Petroleum processing or storage plants
5. Radioactive material storage, processing plants or nuclear reactors
6. Mortuaries
7. Cemeteries
8. Sites with an auxiliary water supply interconnected with PWS (+)
9. Sites with an auxiliary water supply not interconnected with PWS
10. Premises with more than one connection to the PWS (++++)
11. Recycled water (++)(+++)
12. Recycled water interconnected to piping system that contains water received from a PWS (+)
13. Graywater systems, as defined in California Water Code Section 14876, that are interconnected
to a piping system that is connected to a PWS
14. Medical facilities
15. Kidney dialysis facilities
16. Dental office with water-connected equipment
17. Veterinarian facilities
18. Chemical plants
19. Laboratories
20. Biotech facilities
21. Electronics manufacture
22. Dry cleaner facilities
23. Industrial or commercial laundry facilities
24. Metal-plating facilities
25. Business park with a single meter serving multiple businesses
26. Marine-port facilities
27. Car wash facilities
28. Mobile home park, RV park, or campgrounds with RV hookups
29. Hotels/motels
30. Gas stations
31. Fire stations
32. Solid waste disposal facilities
33. Pet groomers
34. Agricultural premises
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35. Hazard assessment access denied or restricted
36. Railroad maintenance facilities
37. Incarceration facilities (e.g. prisons)
38. Temporary connections to fire hydrants for miscellaneous uses, including construction
39. Private water distribution mains
40. Drinking water storage tank overflow connected to a sump or storm drain (+)
41. Airports
(+) Premise isolated by air gap only except as allowed through CCCPH Section 3.2.2 (c)
(++) Dual-plumbed use areas established per CCR Title 22, Section 60313 through 60316 where recycled
water is used for individually owned residential unit.
(+++) Residences using recycled water for landscape irrigation as part of an approved dual plumbed use
area established pursuant to CCR Title 22, sections 60313 through 60316 shall use a DC backflow
prevention device. The recycled water supplier may obtain approval of the local public water supplier or
the State Water Board, if the water supplier is also the supplier of the recycled water, to utilize an
alternative backflow protection plan that includes an annual inspection of both the recycled water and
potable water systems and an annual shutdown test of the recycled water and potable water systems
pursuant to subsection 60316(a) in lieu of any backflow prevention assembly.
(++++) All connections must receive at least the same level of protection (e.g. if one connection requires
an RP then all connections must have RPs installed).
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APPENDIX C – RELATED STATUTES AND REGULATIONS
The following laws and regulations are considered related or tangential to the CCCPH, and are
included in a descriptive format to provide additional, relevant background information
California Laws and Regulations
In addition to the California SDWA statutory requirements cited in CCCPH Chapter 1, section 1.3.1,
California has statutes addressing certain authorities and requirements that may have influenced the
CCCPH or may otherwise be of interest.
• Urban and community water systems must have a written policy on discontinuation of
residential service for nonpayment and must not discontinue residential service for
nonpayment if certain conditions are met. (CHSC sections 116900 – 116926)
• Senate Bill 1263 (2017) requires that before a person submits an application for a permit for
a proposed new public water system, the person shall first submit a preliminary technical
report which must include a cost comparison of a new public water system and consolidations
with an existing system. (CHSC section 116527)
• Effective June 24, 2015, Senate Bill 88 (SB 88) (Statutes 2015, Chapter 27) added sections
116680-116684 to the CHSC, allowing the State Water Board to require certain water systems
that consistently fail to provide safe drinking water to consolidate with, or receive an
extension of service from, another public water system. The consolidation can be physical or
managerial.
• Local health officers may maintain programs for the control of cross-connections by water
users, within water users’ premises, where public exposure to backflow may occur. Such
programs may include water user premises inspections, collection of fees, certification of
backflow prevention assembly1 (BPA) testers, and other discretionary elements. Local health
officer BPA tester certification standards must be consistent with the standards prescribed in
the CCCPH. Water users are required to comply with all orders, instructions, regulations, and
notices from the local health officer regarding installation, testing, and maintenance of a BPA.
(CHSC sections 116800 - 116820).
• Pursuant to the California Building Standards Law (CHSC sections 18901 – 18949.31), the
California Building Standards Commission (CBSC) must administer the processes related to
the adoption, approval, and publication of regulations referred to as the California Building
Standards Code (Title 24, California Code of Regulation). Title 24 serves as the basis for the
minimum design and construction of buildings in California and includes the California
Plumbing Code (Part 5 of Title 24), which contains requirements pertaining to cross-
connection control and backflow prevention.
• A backflow preventer intended to convey or dispense water for human consumption via
drinking or cooking must meet California’s “lead free” requirements. (CHSC section 116875)
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• Limits are established for the installation of backflow protection equipment where automatic
fire sprinkler systems are utilized. (CHSC section 13114.7)
• Cross-connection control must be addressed in engineering reports that are required (CCR
Title 22, section 60323) for recycled water projects. (Wat. Code section 13552.8)
• If a public agency requires the use of recycled water for toilet and urinal flushing in a structure
(except certain mental health facilities), the public health agency must prepare an engineering
report that addresses cross-connection control. (Wat. Code section 13554)
• Prior to indoor use of recycled water in a condominium project, the entity delivering the
recycled water must submit a report, for State Water Board approval, and include the
following related to cross-connection control (Wat. Code section 13553(d)(1)):
o The condominium project must be provided with a backflow prevention assembly
approved by the State Water Board.
o The backflow prevention assembly must be inspected and tested annually by a
certified tester.
o The condominium project must be tested by the recycled water agency or local
agency at least once every four years for indications of possible cross- connections
between the condominium’s potable and non-potable systems
• California’s Department of Water Resources was required to convene a task force, known as
the 2002 Recycled Water Task Force, to identify constraints, impediments, and opportunities
for the increased use of recycled water and report to the Legislature by July 1, 2003. The task
force was also asked to advise and make recommendations concerning cross-connection
control, including the applicability of visual inspections instead of pressure tests for cross-
connections between potable and non-potable water systems. (Wat. Code section
13578(b)(1). The final report4 provided the following recommendations to the State Water
Board – Division of Drinking Water (Division):
o Prepare guidance on dual plumbed regulations (22 CCR sections 60313-60316)
consistent with Appendix J of plumbing code (Chapter 15 of 2019 California Plumbing
Code, formerly Chapter 16A).
o Support thorough assessment of risk associated with cross-connections between
disinfection tertiary recycled water and potable water.
o Ensure uniform interpretation of cross-connection control requirement of Title 22
regulations (recycled water) and Title 17 (cross-connection control regulations)
o Recommend stakeholders to review draft Title 17 regulations.
• A person engaged in the salvage, purchase, or sale of scrap metal who knowingly possesses a
backflow prevention assembly (or connections to the assembly or any part of the assembly),
or who failed to report the possession of such items, which was previously owned by a utility
or public agency, is guilty of a crime. (Pen. Code section 496e)
• Junk dealers or recyclers who possess a backflow prevention assembly (or connections to that
assembly or any part of the assembly) without a written certification from the agency or utility
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owning or previously owning the assembly will be liable to the agency or utility for the
wrongful possession. (Civ. Code section 3336.5 and, similarly, Bus. & Prof. Code section
21609.1)
Please note that a number of the codes, regulations, and statutes cited above are implemented under
the authority of regulatory entities other than the State Water Board and would therefore be beyond
the scope of this CCCPH. The intent of providing such citations is to increase general awareness with
respect to other potential statutory requirements associated with cross-connection control. The list
is not exhaustive and does not include other requirements that may exist, including those via
regulations that may have been adopted by an appropriate regulatory entity.
Federal Laws and Regulations
All suppliers of domestic water to the public are subject to regulations adopted by the U.S.
Environmental Protection Agency (EPA) under the U.S. Safe Drinking Water Act (SDWA) of 1974, as
amended (42 U.S.C. section 300f et seq.), as well as by the State Board under the California SDWA
(Health & Saf. Code, div. 104, pt. 12, ch. 4, section 116270 et seq.). Additionally, the State Water
Board has been delegated primacy - the responsibility and authority to administer U.S. EPA's drinking
water regulations within California – on the condition that California adopt enforceable requirements
no less stringent than U.S. EPA's.
The U.S. EPA currently has no distinct cross-connection control requirements that apply broadly to
public water systems (PWS); however, the importance of cross-connection control is evident by the
issue papers and guidance documents developed by U.S. EPA and their recognition that cross-
connections and backflow represent a significant public health risk (see discussion in Chapter 2).
Although U.S. EPA currently has no distinct cross-connection control requirements, the subject of
cross-connection or backflow prevention assemblies is included in the U.S. SDWA and the Code of
Federal Regulations (C.F.R.) in relation to PWS, including the following:5
• If used exclusively for non-potable services, a backflow prevention assembly is exempt from
the federal lead prohibitions. (42, U.S.C. section 300g)
• Allows increasing disinfectant concentrations in a PWS distribution system in the event of a
cross-connection (backflow) event. (40 C.F.R. section 141.130(d))
• Proper maintenance of the distribution system, including cross-connection control, is
identified as a best available technology (BAT) for microbial contaminant control. (40 C.F.R.
section 141.63(e))
• Under the federal Revised Total Coliform Rule, a PWS having a cross-connection control
program is one of the enhancements necessary to reduce monitoring for a PWS that had been
under an increased monitoring frequency. (40 C.F.R. section 141.854(h)(2))
• Under the federal Revised Total Coliform Rule, a PWS having a cross-connection control
program is a criterion for a state to allow a reduced monitoring frequency (40 C.F.R. section
141.855(d)(1))
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• If a state allows the monitoring frequency reductions previously mentioned under the federal
Revised Total Coliform Rule, a state is required to include in its primacy package to U.S. EPA
how a PWS will be required to demonstrate cross-connection control. (40 C.F.R. section
142.16(q))
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APPENDIX D – SAMPLE BACKFLOW INCIDENT RESPONSE FORM
BACKFLOW INCIDENT REPORT FORM
Many backflow incidents occur that are not reported. This is usually because they are of short duration, are not detected,
the customer needs to be made aware they should be reported, or it may not be known to whom the incident should be
reported. If you have any knowledge regarding incidents, please complete the form below and return it to the Municipal
Engineer at the above address.
Reporting Agency: ________________________________ Report Date: _____________
Reported By: ______________________________________ Position: ________________
Mail Address: ______________________________________ City: ___________________
Province: ________ Postal Code: _______________ Telephone: ______________
Date of Incident: ____________________________________ Time of Occurrence: ______
General Location (Street, etc.): ____________________________________________________
1. Backflow Originated From:
Name of Premise:
Street Address: _________________________________ City: _____________________
Contact Person: ___________________________ Telephone: ________________
Type of Business: __________________________________________________________
2. Description of Contaminant(s):
(Attach Chemical Analysis if available)
________________________________________________________________________________________________
____________________________________________________________
3. Distribution of Contaminant(s):
Contained within customer’s property: Yes: ___ No: ___
Number of persons affected: _______
4. Effect of Contamination:
Illness reported: _________________________________________________________________
Physical irritation reported: ________________________________________________________
______________________________________________________________________________
5. Cross Connection Source of Contaminant:
(boiler, chemical pump, irrigation system, etc.)
________________________________________________________________________________________________
__________________________________________________________
6. Cause of Backflow:
(main break, fire flow, etc.)
________________________________________________________________________________________________
____________________________________________________________
7. Corrective Measures Taken to Restore Water Quality:
(main flushing, disinfection, etc.)
________________________________________________________________________________________________
____________________________________________________________
8. Corrective Action Ordered to Eliminate or Protect from Cross Connection:
(type of backflow preventer, location, etc.)
________________________________________________________________________________________________
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____________________________________________________________
9. Previous Cross Connection Survey of Premise:
Date: _____________________________ By: ________________________________
10. Type(s) of Backflow Preventer Isolating Property:
RP: ___ RPDA: ___ DCVA: ___ DCDA: ___ PVB: ___ SVBA: ___
AVB: ___ Air Gap: ___ None: ___ Other Type: __________________________
11. Date of Latest Test of Device: _____________________________
12. Notification of Health Department:
Date: _______________ Time: __________ Person Notified: ___________________
Attach sheets containing any additional information, sketches, etc., to the back of this form.
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APPENDIX E – ORDINANCE
Chapter 13.04 CROSS CONNECTION REGULATIONS
13.04.010 Purpose.
This chapter provides for a reasonable and effective means of protecting the city potable water system, and
where appropriate its recycled water system, from backflow, in compliance with the California Code of Regulations,
Title 17, Division 1, Chapter 5.
(Ord. No. 910, § 4(Exh. A), 9-26-2017)
13.04.020 General provisions.
A. It is the customer's responsibility to protect the water quality in its system when the city requires a backflow
prevention assembly to protect the public system.
B. New potable water service connections shall be installed and existing potable water service connections shall
be upgraded to conform to these requirements.
C. Wherever backflow protection has been found necessary on a water supply line entering a customer's
premises, then any and all water supply lines from the city's mains entering such premises, buildings, or
structures shall be protected by an approved backflow prevention assembly.
D. The provisions and requirements of this chapter are the minimum requirements. Where this chapter imposes
a greater restriction than is imposed or required by other laws, rules, regulations, standards or ordinances, of
or applicable to the city, the provisions of this chapter shall control and be applied; where such other laws,
rules, regulations, standards or ordinances are more restrictive, they shall control and be applied.
(Ord. No. 910, § 4(Exh. A), 9-26-2017)
13.04.030 Definitions.
A. "Approved" means accepted by the city as meeting applicable specifications or as suitable for the proposed
use.
B. "Approved device" means a backflow-prevention device which is manufactured in full conformance with the
standards established by the American Water Works Association (AWWA) and has completely met the
laboratory and field performance specifications of the Foundation for Cross-Connection Control and Hydraulic
Research (FCCC&HR) of the University of Southern California.
C. "Auxiliary water supply" means any water supply on or available to premises other than potable water supplied
by the city potable water system.
D. "AWWA standard" means a standard developed and approved by the American Water Works Association.
E. "Backflow" means the flow of water or other liquids, mixtures or substances, under positive or reduced
pressure from the customer's system into the city potable water system.
F. "Backflow prevention assembly" means an assembly or means designed to prevent backflow or back -
siphonage. Backflow prevention assemblies included the following devices:
1. "Air gap separation (AG)" which is a physical break between the service connection and a receiving
vessel on the customer's system, where all piping between the service connection and the
receiving vessel is entirely visible and the air-gap separation is greater than one inch and at least
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double the diameter of the supply pipe, measured vertically from the flood rim of the customer's
receiving vessel to the supply pipe from the service connection.
2. "Reduced pressure principle backflow prevention assembly (RP)" is an assembly consisting of two
independently operating check valves with an automatically operating differential relief valve
located between the two checks, a tightly closing shut-off valve on each side of the check valve
assembly, and properly located test cocks for the testing of each check valve and the relief valve.
3. "Double check valve assembly (DC)" is an assembly of two independently operating, spring loaded
check valves with tightly closing shut-off valves on each side of the check valve assembly and
properly located test cocks for the testing of each check valve.
G. "Backpressure" means a condition in which the owner's system pressure is greater than the city water system
pressure.
H. "Back-siphonage" means the flow of water or other liquids, mixtures or substances from the customer's system
into the city potable water system caused by a reduction or loss of pressure within the city potable water
system.
I. "Certified tester" means:
1. A person who is certified by the city to perform testing of backflow prevention devices, who has
completed training and received certification by an AWWA sponsored backflow device testing
certification program or the University of Southern California Backflow Prevention Device Testing
School and who possesses a valid city business license.
2. A service representative of the manufacturer of the backflow-prevention device approved by the
engineer and possessing a valid city business license.
3. All city personnel, as authorized by the engineer.
J. "City" means the city of Rohnert Park, California.
K. "City potable water system" means the potable water distribution system owned and operated by the city,
including the service connection to a potable water main.
L. "Contamination" means an impairment of the quality of the water supply of the city potable water system by
sewage, industrial fluids or waste liquids, compounds or other materials to a degree which creates an actual
hazard to the public health through poisoning or through the spread of disease.
M. "Cross-connection" means an unprotected actual or potential connection between the city potable water
system and any source or system within a customer's premises and/or customer's system which contains water
or any substance that is not or cannot be approved as a potable water supply. Bypass arrangements, jumper
connections, removable sections, swivel and changeover devices, or other devices through which backflow or
back-siphonage could occur, shall be considered to be cross-connections.
N. "Customer" or "user" means any person obtaining water from the city water supply system.
O. "Customer's system" means the potable water piping system located immediately downstream from a meter.
P. "Degree of hazard" means the potential risk to public health and the adverse effect of the hazard upon the
potable water system.
Q. "Engineer" means the city engineer of the city, or a designee.
R. "Health agency" means the California Division of Drinking Water.
S. "Local health agency" means the Sonoma County Department of Health.
T. "Owner" means any person, who has legal title to, or a right to the use or occupancy of, a property.
U. "Nonpotable water" means water which is not safe for human consumption.
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V. "Person" means any individual, partnership, company, public or private corporation, political subdivision or
agency of the United States State of California or other governmental entity.
W. "Pollutant" means a foreign substance that, if permitted to get in the public water system, will degrade its
quality so as to constitute a moderate hazard, or impair the usefulness or quality of the water to a degree
which does not create an actual hazard to the public health but which does adversely and unreasonable affect
such water for domestic use.
X. "Potable water supply: means a water supply which, according to recognized standards and the public health
authority having jurisdiction, is safe for human consumption.
Y. "Pollution" means an impairment of the quality of the potable water supply of the city.
Z. "Premises" means a piece of land together with such buildings and appurtenances located thereon.
AA. "Recycled water" means water which, as a result of treatment of waste, is suitable for uses other than potable
use.
BB. "Service connection" or "user connection" means the water piping system and/or meter connecting the city
potable water system to the customer's system.
(Ord. No. 910, § 4(Exh. A), 9-26-2017)
13.40.040 Requirements for backflow prevention devices.
A. To comply with the California Code of Regulations, the city requires the installation of approved backflow
prevention assemblies or air gaps, by and at the expense of the owner, when the degree of hazard in the
customer's system so warrants, as solely determined by the city.
B. Backflow prevention devices or air-gaps of a type, manufacture and design approved by the engineer shall be
installed by the customer on the customer's system in a location approved by the engineer in the following
described categories:
1. Premises having an auxiliary water supply;
2. Premises and/or customer's systems within which any substance is handled under pressure or any
other fashion that, in the opinion of the engineer, could potentially permit backflow or back-
siphonage into the city potable water system, including water that originated from the city water
system;
3. Premises and/or customer's systems which have more than one service connection and which, in
the opinion of the engineer, contain cross-connections or the potential for cross-connections
which could result in the pollution or the contamination of the city potable water system in the
event of backflow or back-siphonage;
4. Premises and/or customer's systems which, in the opinion of the engineer, contain cross-
connections or the potential for cross-connections which could result in the pollution or
contamination of the potable city water system in the event of backflow or back-siphonage;
5. Premises and/or customer's systems where, in the opinion of the engineer, the potential for
contamination is such as to require an air-gap separation system;
6. Premises having a gray water use system as defined by California Code of Regulations, Title 24,
Part 5; and
7. Premises having a recycled water system as defined by the State of California Code of Regulations,
Title 22, Division 4, Chapter 3.
8. On tank trucks and spray tanks of forty-nine gallons or more, that will connect to the city's system.
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9. All temporary water cross connections, including but not limited to the use of fire hydrants or
blow-offs for construction water, flushing lines, or similar purposes.
(Ord. No. 910, § 4(Exh. A), 9-26-2017)
13.04.050 Ownership of backflow devices.
Backflow-prevention devices and air-gaps shall be and remain the property of the customer.
(Ord. No. 910, § 4(Exh. A), 9-26-2017)
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13.04.060 Type of protection required.
The type of backflow protection required shall be commensurate with the degree of hazard that exists on the
customer's premises. The minimum types of backflow protection required to protect the public water supply, at the
customer's water connection to premises with varying degrees of hazard are given in Table 1. The owner may choose
a higher level of protection than required by the city. Situations which are not covered in Table 1 shall be evaluated
on a case by case basis and the appropriate backflow protection shall be determined by the engineer.
TABLE l
TYPE OF PROTECTION REQUIRED
Degree of Hazard Minimum
Level
of
Backflow
Prevention
A Sewage and Hazardous Substances
Premises where the public water system is used to supplement the
recycled water supply.
AG
Premises where there are wastewater pumping and/or treatment
plants and there is no inter-connection with the potable water system.
This does not include a single family residence that has a sewage lift
pump.
AG1
Premises where recycled water is used and there is no interconnection
with the potable water system.
AG1
Premises where hazardous substances are handled in any manner in
which the substances may enter a potable water system. This does not
include a single family residence that has a sewage lift pump.
AG1
Premises where there are irrigation systems into which fertilizers,
herbicides, or pesticides are, or can be, injected.
RP
B Auxiliary Water Supplies
Premises where there is an unapproved auxiliary water supply which is
interconnected with the public water system.
AG2
Premises where there is an unapproved auxiliary water supply and there
are no interconnections with the public water system.
RP3
C Fire Protection Systems
Premises where the fire system is directly supplied from the public
water system and there is an approved auxiliary water supply on or to
the premises (not interconnected).
DC
Premises where the fire system is supplied from the public water system
and interconnected with an unapproved auxiliary water supply.
AG1
Premises where the fire system is supplied from the public water system
and where either elevated storage tanks or fire pumps which take
suction from the private reservoirs or tanks are used.
DC
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D Premises where entry is restricted so that inspections for cross-
connections cannot be made with sufficient frequency or at
sufficiently short notice to assure that cross-connections do not exist.
RP
E Premises where there is a repeated history of cross-connections being
established or re-established.
RP
F In the case of tankers and spray tanks of 49 gallons or more, including
but not limited to fire.
AG/RP
1 An RP may be provided in lieu of an AG if approved by the city and the health agency.
2 A RP or DC may be provided in lieu of an AG if approved by the city and the health agency.
3 A DC may be provided in lieu of a RP if approved by the city and the health agency.
(Ord. No. 910, § 4(Exh. A), 9-26-2017)
13.04.070 Installation of backflow devices.
A. New Service Connections.
1. At the time of application for potable water service, the engineer will review said application to
determine the need for a backflow-prevention device or air-gap. If the engineer determines that
a backflow-prevention device or air-gap is required, it shall be the customer's responsibility at
customer's expense to provide for installation of an approved backflow-prevention device or air-
gap in accordance with city standards and at a location approved by the engineer.
2. Installation of a backflow-prevention device or air-gap, where required by the city, shall be a
condition of city potable water service and meter installation.
B. Existing Service Connections without Backflow-Prevention Devices or Air-Gaps. The city may inspect the
premises of existing customers which, in the opinion of the engineer, may require a backflow -prevention
device or air-gap. If the engineer determines that a backflow-prevention device or air-gap is required, the
installation of an approved device or air-gap shall be a condition of continued potable water service from the
city potable water system to the premises and/or customer's systems.
C. Upgrading of Existing Backflow-Prevention Devices or Air-Gaps. An existing backflow-prevention device or air-
gap which, in the opinion of the engineer, is a non-approved device or air-gap that does not provide adequate
protection for the degree of potential hazard from the backflow or back -siphonage from a premises and/or
customer's systems, shall be upgraded at the customer's expense.
(Ord. No. 910, § 4(Exh. A), 9-26-2017)
13.04.080 Testing, maintenance, reporting and repair of backflow prevention devices.
A. Each customer shall have each backflow device tested at least annually by a certified tester. All inspections,
testing, maintenance, and reporting shall be done at the expense of the customer.
B. The director of public works shall have authority to establish deadlines for submission of annual testing. Where
the director of public works determines that there is potential for backflow or back -siphonage they may
require tests at intervals that are more frequent by notification in writing.
C. The customer shall be responsible for maintenance and repair of each backflow prevention device required
under this chapter. If a device should fail to pass inspection and testing the customer shall, within thirty days
after notification of test results, provide for the maintenance and repair of the device.
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D. The customer shall maintain any backflow prevention device that is required under this chapter in proper
working order as a condition of continued water service. Failure by the customer to install devices required by
this chapter, test and report results as required by this chapter, or to timely repair a backflow device within
the time allowed by the director of public works, shall subject the customer to a termination of potable water
service to the premises.
E. Reports of tests of backflow prevention shall be submitted in a format or a program as approved by the director
of public works.
F. The city council may by resolution establish a fee covering the administrative costs to the city of enforcing the
monitoring and reporting required under this section. Such fee may be collected in any manner determined
appropriate by the director.
(Ord. No. 910, § 4(Exh. A), 9-26-2017; Ord. No. 963, § 1, 4-26-2022) Editor's note(s)—Ord. No. 963, § 1, adopted Apr.
26, 2022, amended the title of § 13.04.080 to read as herein set out. The former § 13.04.080 title pertained to
testing, maintenance and repair of backflow devices.