If you want to make change to your account, please fill out our electronic PDF form and email directly to the Cross Connection Program by pressing "Submit by Email to Cross Connections" link at the top right of your form.
Title 8 of the Los Angeles County Code requires all persons having backflow prevention assemblies to pay the Department of Public Health an annual administrative fee of $37 per assembly. This fee is for the annual processing of the test notice(s), overseeing the testing and certifying backflow prevention assembly testers (Sec. 8.04.728). Note: Test notices are sent separately from invoices.
On the form , select "Make changes or corrections to my account". Fill in the changes or corrections in the appropriate boxes at the bottom of your form.
On the form , select "Change the address where invoices are sent" and complete in the information in "Invoice Mailing Address" at the bottom of your form.
On the form , select "Change the address where test notices are sent" and complete in the information in "Test Notice Mailing Address" at the bottom of your form.
On the form , select "I no longer control, manage or own the backflow assembly at this property". Include your Facility ID (FA#######). Email your form to Cross Connection Program.
If you have removed a backflow prevention assembly from your property, building or facility, select "I want to remove the following backflow prevention assembly or assemblies" on the form and enter your backflow assembly ID numbers (BD#######) you want to remove. Include your reason for removal. Email your form to the Cross Connection Program as soon as possible. Deduct $37 from the invoice for each assembly that you want removed and send in the balance of the payment. If you are deducting an assembly, you will not be able to make an online payment. A member of the Cross Connection Program will verify the removal.
On the form , select "I want a copy of an invoice" and enter your account number (AR#######).
On the form , select "I want a copy of a test notice" and enter your backflow prevention assembly number (BD#######) or your facility number (FA#######) if you want all the backflow prevention assemblies for that facility.
Normally, each property with backflow prevention assemblies receives one invoice. If you are receiving one invoice for several properties and you want to have a separate invoices for each property. Select "I want a separate invoice for each property" on the form . Please include your Facility ID number (FA#######) and Owner ID number (OW#######).
Each physical address with backflow prevention assemblies receives one invoice. An exception to this is a campus setting where you may arrange to have a consolidated invoice for a property/parcel that has multiple addresses on the same property/parcel. On the form , select "I want to consolidate multiple invoices for buildings on the same property/parcel into one". List your facility numbers (FA#######) of the properties in question and your owner number (OW#######).
If you have any questions, select "Billing or other questions" and enter your question on the form . Press "Submit by Email to Cross Connections" button to submit the form directly to the Cross Connection and Water Pollution Control Program.
