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Moffat Water Supply Corporation Water Service Line Material Survey
Please complete the form to submit the material of your water service line.
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1.
First Name
(Required.)
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2.
Last Name
(Required.)
3.
Phone Number
4.
Email
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5.
Property Address
(Required.)
6.
Account Number - Please enter the account number found on your water bill.
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7.
Type of Occupancy
(Required.)
Owner
Renter/Tenant
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8.
What type of material is used for the water service lines? -The water line that runs from the meter to your home or building.
(Required.)
PVC (white plastic)
Lead (blue grey color)
PEX (red or blue tubing)
HDPE (black or blue hard plastic tubing)
Copper (bronze or green color)
Galvanized Iron/Steel (dull silver/grey color)
Other
Unknown
Unknown, but installed after lead state ban - 1988
Unknown, but not lead
Unknown, but could contain lead
Combination, but could contain lead
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9.
Please provide the install date of your water service line. If you do not know the install date, please provide the year the home was built.
(Required.)
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10.
Is there a lead connector where your service line is connected to the water meter?
(Required.)
Yes
No
Unknown
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11.
Is there lead solder in the service line?
(Required.)
Yes
No
Unknown
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12.
Does the interior home or building plumbing contain copper pipes with lead solder installed before July 1, 1988
(Required.)
Yes
No
Unknown
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13.
Source of Information - How did you determine the material of your water service line?
(Required.)
Visual Inspection
Lead Test Kit
Plumbing Records
Scratch Test
Other
14.
Add a Photo (optional)
Please provide a photo of your water service line.
Choose File
No file chosen
