Plumbers Create in CertBox
Cross-Connection Control Survey
A Cross-Connection Control Survey is a facility-wide inspection that identifies every point where the potable water supply could connect to a non-potable source, assesses the degree of hazard at each one, and records the backflow protection in place or required.
AWWA Manual M14 (Backflow Prevention and Cross-Connection Control), state plumbing/health codes, local water utility cross-connection control programsValid: 12 months
Sample CCC Survey certificate

Sample CCC Survey with fictional data. All personal details shown are fake.
What it covers
- Facility occupancy type and overall hazard degree
- Each identified cross-connection: location, contaminant source, and hazard degree
- Existing/recommended backflow assembly type (RP, DC, PVB, SVB, or AG)
- Compliant vs remediation-required result
Who needs a CCC Survey?
Commercial and industrial facility owners
Water utilities
Property managers
Plumbing contractors
Create your CCC Survey with CertBox
1
Fill in the form
Pick CCC Survey from the list, fill in the fields on your phone.
2
Compliance checks run
Built-in validation catches missing fields and out-of-range readings.
3
PDF generated instantly
Professional PDF ready to share via secure link or download.
Frequently asked questions about CCC Survey
What is the difference between a cross-connection survey and a backflow test?
A cross-connection control survey is a facility-wide walkthrough that identifies every point where the potable supply could connect to a non-potable source and assesses the hazard degree at each one. A backflow prevention device test (see our Backflow Prevention Test Report) checks a single already-installed assembly's mechanical operation. Most water utilities require both: a periodic survey to catch new hazards, and annual testing of each installed assembly.
Who can perform a cross-connection control survey?
Recognized national credentials include the ASSE 5120 Cross-Connection Control Surveyor certification and the ABPA Cross-Connection Control Specialist (CCCS) certification. Many states and water utilities also run their own equivalent certification program — check what your local water purveyor requires.