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* 1. First Name

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* 2. Last Name

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* 3. Address

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* 4. Please enter your email address

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* 5. Please enter your phone number

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* 6. Select one of the following: Which material is your Water Service line made out of? Please be sure to follow the identification instructions carefully. Refer to the Borough of Netcong's website (www.netcong.org) if you are unsure, and make an appointment with a borough representative if you are in need of assistance with the identification of the pipe's material.

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* 7. Is the pipe magnetic?

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* 8. Please provide any additional information that you believe the Borough may need to know.

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