Drinking Water Service Line Question Title * 1. What is the property address (Required.) Question Title * 2. Your Name (Required.) Question Title * 3. Phone Number Cell Home Work Question Title * 4. Email Question Title * 5. What year was your home built? Before 1900 1900-1950 1951-1979 1980's 1990-Present Unknown Question Title * 6. Have you replaced or repaired your water service line? Yes No If Yes, please explain when & type of improvement Question Title * 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): Question Title * 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 Question Title * 9. Do you have access to the service line entering your house through a: Basement Crawl Space Not accessible Other (please specify) Question Title * 10. Are you interested in OPTIONAL testing of your water service line for lead, if the property is deemed eligible? Yes No Done