Nebraska law mandates that public water supply consumers inspect their facilities for cross connections at least once every five years.

To reduce costs, we’re encouraging residents to complete the online survey. However, we understand that not all residents have internet access. If you don’t complete the online survey by 1 October 2025, we will mail you a paper version.

Important: All residents must complete this survey to maintain water service.

Why complete the survey?

A cross connection exists wherever your home’s drinking water system could potentially contact contaminated sources. Every home contains these vulnerable points where water pipes and plumbing fixtures create pathways for contamination to enter your drinking water.

When water pressure drops suddenly—due to high demand, a broken water main, or firefighting efforts—contaminated water can be pulled backward through unprotected cross connections into your plumbing system. This reverse flow, called backflow, poses a serious health risk.

While SID 5 maintains an exceptionally reliable water distribution system, pressure fluctuations can occur. Without proper protection at cross connection points, these pressure changes can allow chemicals, toxins, and harmful bacteria to contaminate the water flowing from your taps.

Taking proactive steps to identify and protect cross connections in your home safeguards your family’s drinking water supply. Information on types of cross connections can be found here.

Please email questions to utilities@buccaneerbay-ne.org

SID 5 Cross Connect Survey

Please enable JavaScript in your browser to complete this form.

Homeowner/Resident Name *

First

Last

Service Address – House Number *

The house number. i.e. 2510

Service Address – Street *Select a StreetBAY CIRBAY RDBECKER CTBUCCANEER BLVDCAPE HORN CIRCAPTAIN MORGAN CTCYPRESS CTDAVY JONES CIRDAVY JONES DREWEL CTFAIRWAY CIRFAIRWAY DRFOUNTAIN CIRISLAND DRLAKESIDE CIRLAKESIDE DRLAKEVIEW CIRRAINEY CIRRIDGEWAY RDSHORELINE CIRSPYGLASS CTSTERLING CTTREASURE ISLAND RDWATERSEDGE CIRWEDGEWOOD CTWINDWARD CTWINDWARD DR

Email *

We will reach out via email with any additional questions.

What is the diameter of your water service line? *— Select a Value —3/4″1″1 1/2″2″3″4″

Click here for help with determining the size of your service line.

What is the composition of your water service line? *— Select a Value —CopperGalvanized SteelLeadPlastic (PVC, CPVC)Unknown

Click here for help with determining the composition of your service line.

Do all hose spigots have a built-in or added vacuum breaker? *— Select Yes or No —YesNo

Click here for more information on hose spigot vacuum breakers.

Do you have a water softener or water filtration system? *— Select Yes or No —YesNo

Click here for more information on water softener/filtration cross connects.

Is the water softener or water filtration system drain protected by an air gap? *— Select a Value — YesNo

Do you have a lawn irrigation system? *— Select Yes or No —YesNo

Click here for more information on lawn irrigation cross connects.

Does the lawn irrigation system have a testable backflow preventer? *— Select Yes or No —YesNo

Do you have a hot tub or swimming pool? *— Select Yes or No —YesNo

Click here for more information on hot tub/pool cross connects.

How do you fill your hot tub or swimming pool? *— Select a Value —HoseConnected to Water System

Does the hot tub or swimming pool have a testable backflow preventer? *— Select Yes or No —YesNo

Do you have a private well or other source of water? *— Select Yes or No —YesNo

Click here for more information on well/other water source cross connects.

Does the private well or other source of water have a testable backflow preventer? *— Select Yes or No —YesNo

Do you have medical, dental or dialysis equipment connected to the water supply? *— Select Yes or No —YesNo

Click here for more information on medical/dental equipment cross connects.

Does the medical, dental or dialysis equipment have a testable backflow preventer? *— Select Yes or No —YesNo

Do you use a hot water or steam boiler to heat your home? *— Select Yes or No —YesNo

Click here for more information on hot water/steam boiler cross connects.

Does the hot water or steam boiler have a testable backflow preventer? *— Select Yes or No —YesNo

Do you have any other possible plumbing cross connections? (i.e. water features, photo, chemical or veterinarian labs, etc.) *— Select Yes or No —YesNo

Click here for more information on other potential cross connects.

List of other possible cross connections

Any additional information you would like to provide?

Submit