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Lead Service Line Inventory (LSLI) Customer Survey
Southwest Water Authority
1.
What is your first name?
2.
What is your last name?
*
3.
What is your account number? (Can find on bill)
(Required.)
4.
What is your phone number?
5.
What is your email address?
6.
What is your 911 property address? (Location of the account/service)
7.
Building Type/Use
Single Family
Multi Family
School
Commercial Child Care
Child Care Licensed (in home)
Commercial
Public/Government Owner
8.
Type of Occupancy
Owner
Renter/Tenant
9.
Type of Service Usage
Domestic Drinking Water
Agricultural/Pasture Tap
Other
10.
Number of Homes Connected to a Single Service
11.
Service Line Material (Materials used from the SWPP Meter Pit or Curb Stop, to the first shut off valve inside the building, or point of use.) The image above represents a simple configuration of a water service line. SWA is interested in the portion labeled 'Customer Owned Service Line' for our purposes. Below are four images of service line materials you may encounter, along with methods that will help you confirm the material.
Lead
Copper
Galvanized Steel
PVC/Plastic
HDPE (Black Poly)
PEX
Asbestos-Cement
Other Non-Lead
Unknown
Not Yet Installed
12.
Pipe Identification Methods
13.
How did you verify your service line type?
Visual Inspection
Plumbing Records
Scratch Test (see pipe identification methods above)
Other (please specify)
14.
Service Line Installation Date
Date:
Not Yet Installed (mark with x)
Unknown (mark with x)
If unknown, provide the year the home/building was built
15.
Add a photo of the water service line entering inside the building, if possible
Choose File
No file chosen
16.
Building Plumbing Material Installation Date
Before 1989
Between 1989 and 2014
After 2014
Unknown
17.
Building Primary Plumbing Material 1: (Most common plumbing material used)
Copper with Solder
Galvanized Steel
PVC
PEX
Other Non-Lead
Unknown
18.
Building Primary Plumbing Material 2: (Second most common plumbing material, if any)
Copper with Solder
Galvanized Steel
PVC
PEX
Other Non-Lead
Unknown
19.
Point of Use Treatment Devices (such as a filter on faucet, RO system under sink, Carbon canister on faucet)
Yes
No
20.
Point of Entry Treatment Devices (such as Whole House Filter/Treatment, Water Softener or RO Unit)
Yes
No
