This version of the form is not currently in use and is provided for reference only. Download this version of Form EQP5969 for the current year.
This is a legal form that was released by the Michigan Department of Environment, Great Lakes, and Energy - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form EQP5969?
A: Form EQP5969 is a report used to document water supply cross connections for systems serving only residential accounts in the state of Michigan.
Q: What is a water supply cross connection?
A: A water supply cross connection is a physical connection between a potable (drinking) water supply and a non-potable source, such as a plumbing fixture, process piping, or irrigation system.
Q: Why is it important to report water supply cross connections?
A: Reporting water supply cross connections is important to prevent contamination of the drinking water supply, which can pose health risks to residents.
Q: Who needs to fill out Form EQP5969?
A: Form EQP5969 needs to be filled out by systems serving only residential accounts in the state of Michigan.
Q: What information is required on Form EQP5969?
A: Form EQP5969 requires information about the system's name, location, contact person, description of cross connections, and the actions taken to prevent backflow of contaminants.
Q: Are there any fees associated with submitting Form EQP5969?
A: No, there are no fees associated with submitting Form EQP5969.
Form Details:
Download a printable version of Form EQP5969 by clicking the link below or browse more documents and templates provided by the Michigan Department of Environment, Great Lakes, and Energy.