City of Green Bay | Green Bay Water Utility

Statement regarding water service line as required under Sec. 21.11, Green Bay General Ordinances

* 1. The address of the property is...

* 2. I am the...

* 3. Who inspected the water service line at the above address (from its point of entry into the building to its connection with the water meter) in order to determine whether the water service line is lead, copper, galvanized steel, plastic or other material (How to Identify Private Water Service Line Material)?

* 4. I have determined from the above inspection that the property does/does not contain a lead water service line.