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Cross-Connection Control Survey

Nebraska’s Safe Drinking Water Act requires consumers of public water systems to survey their residences not less than once every 5 years. Completing and submitting this form fulfills this requirement. Failure to complete this form will warrant an inspection or disconnection of water service.

Customer Information

Your Account Number is shown on your utility bill or you may contact City Hall at 402-694-6992 for assistance.

Survey Questions

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