Skip to content
Lead Inventory
1.
Name of person completing this survey:
2.
Email Address
3.
Phone Number
4.
Property Street Address
5.
Year Built
6.
Structure Type:
Single family home
Multi-family (duplex/quadraplex)
Building
Other (please specify)
7.
What pipe material is the service line entering your house, foundation or building made of?
Lead
Copper
Galvanized steel
PVC
HDPE
PEX
Asbestos-cement
Other non lead
Unknown
8.
What year was your service line installed? (May be year structure built)
9.
What size pipe is the service line entering your house or building? (in inches)
10.
What material are the plumbing pipes in your house or building mostly made of?
Lead
Copper
Galvanized steel
PVC
HDPE
PEX
Asbestos-cement
Other non lead
Unknown
11.
What is the second most material the plumbing pipes are made of?
Lead
Copper
Galvanized steel
PVC
HDPE
PEX
Asbestos-cement
Other non lead
Unknown
12.
How old are the pipes inside your house?
Before 1989
1989-2014
After 2014
Unknown
13.
Do you have a water softener, a whole home water purification system, reverse osmosis system, faucet filter, or any other treatment device installed in your house or building?
Yes
No
14.
If your home or building meets the criteria for lead and copper sampling, would you be willing to participate in testing? This would include RWD10 bringing you an empty bottle and instructions on collecting the sample and picking up the next day.
Yes
No