Form Center

2. The EPA has mandated reporting of water service pipe materials. This survey is your way of helping us to accurately report information and keep our community safe.

4. Name*
5. Email Address*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Fax Number
16. Name of Person Reporting*
18. Inspected By*
    -- Select One --MyselfA Licensed Plumber
19. Upload Photo of Water Meter & Pipe Point of Entry*
21. Service Line Material*
    -- Select One --LeadCopperGalvanized Steel
23. Comments if needed
25. Service Line Material
    Identification Guide

    For Helpful Tips on how to test

Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field