Appendix A Appendix B

Partial List of Illustrations of Plumbing Hazards Backsiphonage

Fixtures with Direct Sewer, sanitary The following illustrates typical undersized water service line Connections Sewer, storm plumbing installations where reduces the pressure at the Swimming pool backsiphonage is possible. water closets to atmospheric producing a reversal of the flow. Description C. Suggested Correction: The Backsiphonage water connection at the bedpan Air conditioning, air washer Fixtures with wash sink and the sterilizer Air conditioning, chilled water Submerged Inlets Case I (Fig. 44) should be provided with Air conditioning, condenser A. Contact Point: A rubber properly installed backflow water hose is submerged in a bedpan preventers. Description Air line wash sink. Aspirator, laboratory Baptismal fount B. Causes of Reversed Flow: Aspirator, medical Bathtub (I) A sterilizer connected to the Backsiphonage water supply is allowed to cool Aspirator, weedicide and Bedpan washer, flushing rim Case 2 (Fig. 45) without opening the air vent. fertilizer sprayer Bidet As it cools, the pressure within A. Contact Point: A rubber Autoclave and sterilizer Brine tank the sealed sterilizer drops below hose is submerged in a labora- Auxiliary system, industrial Cooling tower atmospheric producing a tory sink. Auxiliary system, surface water Cuspidor vacuum which draws the B. Cause of Reversed Flow: Auxiliary system, unapproved Drinking fountain polluted water into the sterilizer Two opposite multi-story contaminating its contents. (2) buildings are connected to the well supply Floor drain, flushing rim Boiler system The flushing of several flush same water main, which often Garbage can washer valve toilets on a lower floor lacks adequate pressure. The Chemical feeder, pot-type Ice maker which are connected to an building on the right has Chlorinator Laboratory sink, serrated nozzle installed a booster pump. Coffee urn Laundry machine FIGURE 44. Backsiphonage (Case 1). Cooling system Lavatory FIGURE 45. Backsiphonage (Case 2). Dishwasher Lawn sprinkler system Fire standpipe or sprinkler Photo laboratory sink system B Sewer flushing manhole Fountain, ornamental A Slop sink, flushing rim Hydraulic equipment Slop sink, threaded supply Laboratory equipment A Steam table Lubrication, pump bearings Urinal, siphon jet blowout Photostat equipment Vegetable peeler Plumber’s friend, pneumatic Water closet, flush tank, Pump, pneumatic ejector ball cock Pump, prime line Water closet, flush valve, Pump, water operated ejector siphon jet BB

B

38 • CROSS-CONNECTION CONTROL MANUAL When the pressure is inad- Backsiphonage Backsiphonage B. Cause of Reversed Flow: equate in the main, the build- Gasoline may enter the ing booster pump starts Case 4 (Fig. 47) Case 5 (Fig. 48) distribution system by gravity pumping, producing a negative A. Contact Point: The water A. Contact Point: The gasoline or by siphonage in the event of pressure in the main and supply to the dishwasher is not storage tank is maintained full a leak or break in the water causing a reversal of flow in the protected by a vacuum breaker. and under pressure by means of main. opposite building. Also, the dishwasher has a solid a direct connection to the city C. Suggested Correction: A C. Suggested Correction: The waste connection to the sewer. water distribution system. reduced pressure principle laboratory sink water outlet B. Cause of Reversed Flow: backflow preventer should be should be provided with a The undersized main serving installed in the line to the vacuum breaker. The water the building is subject to FIGURE 48. gasoline storage tank or a surge service line to the booster pump reduced pressures, and therefore Backsiphonage (Case 5). tank and pump should be should be equipped with a only the first two floors of the provided in that line. device to cut off the pump building are supplied directly when pressure approaches a with city pressure. The upper negative head or vacuum. floors are served from a booster Backsiphonage pump drawing suction directly Case 6 (Fig. 49) from the water service line. Backsiphonage During periods of low city A. Contact Point: There is a pressure, the booster pump submerged inlet in the second Case 3 (Fig. 46) suction creates negative Gasoline floor bathtub. A A. Contact Point: A chemical pressures in the low system, B. Cause of Reversed Flow: tank has a submerged inlet. thereby reversing the flow. Water An automobile breaks a nearby B. Cause of Reversed Flow: C. Suggested Correction: The fire hydrant causing a rush of The plant fire pump draws dishwasher hot and cold water Main water and a negative pressure in suction directly from the city should be supplied through an B the service line to the house, water supply line which is air gap and the waste from the sucking dirty water out of the insufficient to serve normal dishwasher should discharge bathtub. plant requirements and a major through an indirect waste. The C. Suggested Correction: The fire at the same time. During a booster pump should be hot and cold water inlets to the fire emergency, reversed flow equipped with a low-pressure FIGURE 49. bathtub should be above the may occur within the plant. cutoff device. Backsiphonage (Case 6). rim of the tub. C. Suggested Correction: The water service to the chemical FIGURE 47. tank should be provided Backsiphonage (Case 4). through an air gap. A

FIGURE 46. Backsiphonage (Case 3).

CHEMICALS INC.

B

A Dishwasher A

Sewer

High service Low service B B Main

APPENDIX B • 39 Appendix C

C. Suggested Correction: Illustrations of Each pier water outlet should be protected against backflow. The main water service to the Backpressure pier should also be protected against backflow by an air gap The following presents FIGURE 51. or reduced pressure principle illustrations of typical plumbing Backflow (Case 2). backflow preventer. installations where backflow resulting from backpressure is possible. Backflow B Case 4 (Fig. 53)

Backflow A A. Contact Point: A single- valved connection exists Case I (Fig. 50) between the public, potable A. Contact Point: A direct Backflow water supply and the fire- connection from the city supply Case 2 (Fig. 51) sprinkler system of a mill. to the boiler exists as a safety B. Cause of Reversed Flow: measure and for filling the A. Contact Point: Sewage The sprinkler system is nor- system. The boiler water system seeping from a residential mally supplied from a nearby is chemically treated for scale cesspool pollutes the private Backflow lake through a high-pressure prevention and corrosion well which is used for lawn Case 3 (Fig. 52) pump. About the lake are large control. sprinkling. The domestic water numbers of overflowing septic B. Cause of Reversed Flow: system, which is served from a A. Contact Point: A valve tanks. When the valve is left The boiler water recirculation city main, is connected to the connection exists between the open, contaminated lake water pump discharge pressure or well supply by means of a valve. potable and the non potable can be pumped to the public backpressure from the boiler The purpose of the connection systems aboard the ship. supply. may be to prime the well exceeds the city water pressure B. Cause of Reversed Flow: supply for emergency domestic C. Suggested Correction: The and the chemically treated While the ship is connected to use. potable water supply to the fire water is pumped into the the city water supply system system should be through an air domestic system through an B. Cause of Reversed Flow: for the purpose of taking on gap or a reduced pressure open or leaky valve. During periods of low city water for the potable system, principle backflow preventer C. Suggested Correction: As water pressure, possibly when the valve between the potable should be used. minimum protection two check lawn sprinkling is at its peak, and nonpotable systems is valves in series should be the well pump discharge opened, permitting contami- FIGURE 53. provided in the makeup pressure exceeds that of the city nated water to be pumped into Backflow (Case 4). waterline to the boiler system. main and well water is pumped the municipal supply. An air gap separation or into the city supply through an ACME MILLS reduced pressure principle open or leaky valve. FIGURE 52. backflow preventer is better. C. Suggested Correction: The Backflow (Case 3). connection between the well Sprinkler FIGURE 50. water and city water should be System Backflow (Case 1). broken

City main A A B Pump B

To potable A system B Chemical feeder

40 • CROSS-CONNECTION CONTROL MANUAL Appendix D Appendix E

Illustrations of Illustrations of Air Gaps Vacuum Breakers

The following illustrations describe methods of providing an FIGURE 57. air gap discharge to a waste line which may be occasionally or Vacuum breakers. continuously subject to backpressure. Vaccum closes gate FIGURE 54. Brass inset Air gap to sewer subject to backpressure—force main. Air enters here Air preventing rise of D Rubber sleeve contaminated liquids Ball check in fixtures

2xD

Air vent Waste line Flush connection

Pump Cowl nut

FIGURE 55. Air gap to sewer subject to backpressure—gravity drain.

D FIGURE 58. Vacuum breaker arrangement for 2xD an outside hose hydrant. Indirect waste

“A” “A” Ball check Plan Support vanes

Horizontal waste 1" sleeve, sch. 40. FIGURE 56. ½" or ¾" Fire system makeup tank for a Hand wheel gate valve dual water system. Exterior " " ½ or ¾ building wall I.P.S. hose adapter sch. 40. galv.

½" or ¾" vacuum breaker " " Coupling M.I. galv. Nonpotable supply Float valves Potable supply ½ or ¾ 2xD nipple galv. ½" or ¾" Ell. m. M. I. galv. Section “A” “A”

(By permission of Mr. Gustave J. Angele Sr., P.E. formerly Plant Sanitary Engineer, Union Carbide Nuclear To fire system Division, Oak Ridge, Tenn.)

APPENDIX E • 41 Appendix F

Glossary

Air gap The unobstructed Effective Opening The Plumbing The practice, Vacuum Breaker A device vertical distance through minimum cross-sectional materials, and fixtures that permits air into a the free atmosphere area at the point of water used in the installation, water supply distribution between the lowest supply discharge, measured maintenance, extension, line to prevent opening from any pipe or or expressed in terms of and alteration of all piping, backsiphonage. faucet supplying water to a (1) diameter of a circle, or fixtures, appliances and Water Outlet A discharge tank, plumbing fixture, or (2) if the opening is not appurtenances in connec- opening through which other device and the flood- circular, the diameter of a tion with any of the water is supplied to a level rim of the receptacle. circle or equivalent cross- following: sanitary fixture, into the atmo- Backflow The flow of water or sectional area. drainage or storm drainage sphere (except into an open other liquids, mixtures, or Flood-Level Rim The edge of facilities, the venting tank which is part of the substances into the the receptacle from which system and the public or water supply system), to a distributing pipes of a water overflows. private water-supply boiler or heating system, to systems, within or potable supply of water Flushometer Valve A device any devices or equipment adjacent to any building, from any source or sources which discharges a prede- requiring water to operate structure, or conveyance; other than its intended termined quantity of water but which are not part of also the practice and source. Backsiphonage is to fixtures for flushing the plumbing system. materials used in the one type of backflow. purposes and is actuated by Water Supply System The installation, maintenance, Backflow Connection Any direct water pressure. water service pipe, the extension, or alteration of arrangement whereby water-distributing pipes, Free Water Surface A water storm water, liquid waste, backflow can occur. and the necessary connect- surface that is at atmo- or sewerage, and water- ing pipes, fittings, control Backflow Preventer A device spheric pressure. supply systems of any valves, and all appurte- or means to prevent Frostproof Closet A hopper premises to their connec- nances in or adjacent to backflow. Backflow with no water in the bowl tion with any point of the building or premises. Preventer, Reduced and with the trap and public disposal or other The water supply system Pressure Principle Type water supply control valve acceptable terminal. An assembly of differential is part of the plumbing located below frost line. Potable Water Water free valves and check valves system. Indirect Waste Pipe A drain from impurities present including an automatically pipe used to convey liquid in amounts sufficient to opened spillage port to the wastes that does not cause disease or harmful atmosphere. connect directly with the physiological effects. Backsiphonage Backflow drainage system, but which Its bacteriological and resulting from negative discharges into the chemical quality shall pressures in the distribut- drainage system through conform to the require- ing pipes of a potable water an air break into a vented ments of the USEPA supply. trap or a properly vented National Primary Drink- Cross-Connection Any actual and trapped fixture, ing Water Regulations and or potential connection receptacle, or interceptor. the regulations of the between the public water public health authority supply and a source of having jurisdiction. contamination or pollution. Vacuum Any absolute pressure less than that exerted by the atmosphere.

42 • CROSS-CONNECTION CONTROL MANUAL Appendix G

Bibliography

Accepted Procedure and Practice in Canadian Plumbing Code 1980, Cross-Connection Control Program, Manual of Cross-Connection Cross-Connection Control NRCC, No. 17305, Second State of Utah, Oct.1985, Travis Control Practices and Proce- Manual, American Water Printing, Issued by the Black. dures, State of California, Health Works Association, Pacific Associate Committee on the Cross-Connection Control, Water and Welfare Agency, July 1981. Northwest Section, 4th Edition. National Building Code, Quality Division, Colorado Plumbing and Drainage Act Nov. 1985. Natural Research Council of Department of Health. Revised Regulations, Alberta, as amended American Backflow Prevention Canada, Ottawa. March 1983. Cross-Connection by Alberta Regulations (295/80). Association, P.O. Box 1563 Control and Elimination of Cross- Control Survey, New England Regulations Relating To Cross- Akron, Ohio 44309-1563. Connections, Panel Discussion, Water Works Association, Connections, excerpt from the Angele, Gustave Cross-Connection Journal American Water Works August 1987. California Administrative Code, and Backflow Prevention, Association, Vol.50, No.1, 1960. CSA Standards on Vacuum Breakers Title 17, Public Health, 1956. American Water Works Cross-Connection Complications, and Backflow Preventers, B64 Saskatchewan Regulations 8/78, Association. Supplementary The Capital’s Health, Vol. 11, Series 1976 Canadian Standards Regulations Governing Reading library Series – No. No. 9, Dec. 1953, D.C. Dept. of Association, Dec.1976. Plumbing and Drainage S106, New York 10016. Public Health, Washington, Dawson, F. M., and Kalinske, A. D.C. Solar Domestic Hot Water Systems and A Revision of The Notional Plumbing A., Report on Cross-Connections the Water Purveyor, American Code, ASA A40.8-1955, Report Cross-Connection Control, American and Backsiphonage Research, Water Works Association, of the Public Health Service Water Works Association, Technical Bulletin No. 1, Pacific Northwest Section. Technical Committee on British Columbia Section, National Association of Springer, E. K., and Reynolds, K. Plumbing Standards. Sept. 15, Second Edition, Jan.1980. Cross- Plumbing, Heating, Cooling C., 1962, Public Health Service, Connection Control and Backflow Contractors, Washington, D.C. Definitions and Specifications of Double Check Valve Assemblies and Washington 25, D.C. Prevention Device Testing, New Evaluation of Backflow Prevention Reduced Pressure Principle Backflow AWWA Standard For Backflow England Water Works Associa- Devices—A State of the Art, (N B tion, August 1987. Prevention Devices, University of Prevention Devices - Reduced SIR 76-1070) U.S. Environmen- Southern California, School of Pressure Principle and Double Cross-Connection Control and Backflow tal Protection Agency, Water Engineering Dept. 48-101, Jan. Check Valve Types (C509-78), Prevention, Practice and Procedure Supply Division, Washington, 30, 1959. American Water Works Manual, Administrative Manual, D.C., June 1976. Taylor, F. B., and Skodje, M. T., Association, Denver, Colorado, City of Winnipeg, Manitoba. Hendrickson, Howard D. Cross- Cross-Connections, Reaffirmed 1983. Backflow Third Edition, April 1980. A Hazard in Connection Control, Part 1 & 2, All Buildings, Modern Sanitation Prevention and Cross-Connec- Cross-Connection Control, Backflow August & September 1981 tion Control, AWWA Manual and Building Maintenance, Prevention Device Tester issues of Reeves Journal. Vol.14, No.8, Aug. 1962. M14, American Water Works Certification Training Course, How To Prevent Industrial Cross- Association, Denver, Colorado Public Drinking Water Use of Backflow Preventers for Connection Dangers, Water Cross-Connection Control, Joint 1966. Program, Division of Environ- Works Engineering, Feb. 1962. Committee Report, Journal Backflow Prevention and Cross- mental Quality, Department of Manitoba Plumbing Code 1981, Connection Control, Ohio EPA, Natural Resources, State of American Water Works Issued by the Department of , Vol. 50, No.12, Office of Public. Water Supply. Missouri. Association Labour and Manpower of the Dec. 1958. Second Edition, Revised Mar. Cross-Connection Control Manual, Province of Manitoba. 15, 1977. Backflow Prevention Division of Sanitary Engineer- Van Meter, R. O., Backflow Manual of Cross-Connection Prevention Hardware, Water and Devices—Selection, Installation, ing, Tennessee Dept. of Public Control, Dept. of Health and Wastes Engineering, Pt. 1, Sept. Maintenance, and Field Testing, Health, 1975. CSA Standard B64.10M1981. Hospitals, Denver, Colorado, 1970; Pt. 2, Oct. 1970. 1977. Canadian Standards Association, Cross-Connection Control Regula- , Dec.1981. tion in Washington State Manual of Cross-Connection Washington State Dept. of , Foundation for Cross- Backflow—The Manual of Cross- Control Social and Health Services, Connection Control and Connection Prevention in Public Denver, Colorado, 1974. Second Hydraulic Research, University Water Supplies, Missouri Dept. of Edition. Natural Resources. of Southern California, 7th Cross-Connection Control, New Editions, June 1985. York State Dept. of Health, Jan.1981.

APPENDIX G • 43 Appendix H

Cross-Connection Survey Form

Date: ______

Name of Company, Corporation, or Business: ______

______

Address: ______

Name of Contact: ______

Type of Use: Industrial ______Commercial ______Governmental ______Other

Location of Service: ______

Size of Service: ______Inch Metered? Yes No

Require non-interrupted water service? Yes No

Does Boiler Feed utilize chemical additives? Yes No

Is Backflow protection incorporated? Yes No

Are air conditioning cooling towers utilized? Yes No

Is Backflow protection incorporated? Yes No

Is a Water Saver utilized on condensing lines or cooling towers? N/A Yes No

Is the make-up supply line backflow protected? Yes No

Is process water in use, and if so, is it potable supply water or “Raw” water N/A Potable Raw Protected Unprotected

Is fire protection water separate from the potable supply? Yes No

Are Containment Devices in place? Yes No

Summary

Degree of Hazard: High Low

Type of Device recommended for containment: RPZ DCV None

Fixture Outlet protection required? Yes No

If so, where? ______

44 • CROSS-CONNECTION CONTROL MANUAL Appendix I Backflow Prevention Device Test and Maintenance Report

To: ______(water purveyor or regulatory agency) ______

______Attn: Cross-connection Control Section

The cross-connection control device detailed hereon has been tested and maintained as required by the (rules or regulations) of (purveyor or regulatory agency) and is certified to comply with these (rules or regulations). Make of device ______size ______Model Number ______located at ______Serial Number ______

Reduced Pressure Devices Pressure Vacuum Breaker Double Check Devices Relief Valve Air Inlet Check Valve 1st Check 2nd Check Opened at ______psid DC - Closed Opened at ______psid Leaked Tight Closed Tight Initial Test ______psid Did not open RP - ______psid Leaked Leaked

Repairs and Materials Used

DC-Closed Tight Closed Tight Opened at Opened at ______psid Test After Repair RP- ______psid ______psid ______psid

The above is certified to be true. Firm Name ______Certified Tester ______Firm Address ______Cert. Tester No. ______Date ______WH-550 Office of Water (4606M) United States EPA 816-R-03-002 Environmental Protection www.epa.gov/safewater Agency February 2003 Washington, DC 20460

Official Business Penalty for Private Use $300