Skip to content
Batesburg-Leesville Water - Citizen Water Line Questionnaire
*
1.
Homeowner First and Last Name
(Required.)
*
2.
Street Address ( Number and Name)
(Required.)
3.
Apartment/Suite
*
4.
Town
(Required.)
Batesburg
Leesville
5.
What year was the home built? (If you do not know, respond with UNKNOWN)
Unknown
I know my home build year (please specify)
*
6.
Have the in-home water lines ever been replaced?
(Required.)
Yes
No
Unknown
*
7.
Please indicate what type of water line is in the home:
(Required.)
Plastic
Copper
Lead
Unknown
Other
*
8.
What type of Privat Service Line is attached to the home?
(Required.)
Plastic
Copper
Lead
Unknown
Other
*
9.
Please enter your full name as the person submitting this survey and this will count as your signature.
(Required.)