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Drinking Water Service Line
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1.
What is the property address
(Required.)
*
2.
Your Name
(Required.)
3.
Phone Number
Cell
Home
Work
4.
Email
5.
What year was your home built?
Before 1900
1900-1950
1951-1979
1980's
1990-Present
Unknown
6.
Have you replaced or repaired your water service line?
Yes
No
If Yes, please explain when & type of improvement
7.
What type of plumbing do you believe exist from your house to the water meter?
Plastic/PVC
Copper Piper
Lead Pipe
Galvanized Pipe
Unknown
Comments (if applicable):
8.
What level of confidence/knowledge do you have regarding the prior question of service line material?
Very Confident/I know the material of my service line
Somewhat confident/I have some knowledge
Not confident/ I am guessing
I don't have any information and the service line material is unknown
9.
Do you have access to the service line entering your house through a:
Basement
Crawl Space
Not accessible
Other (please specify)
10.
Are you interested in OPTIONAL testing of your water service line for lead, if the property is deemed eligible?
Yes
No