Water Service Line Inventory

Please read the entire test instructions and example provided in your mailing carefully prior to completing this form.

If you own more than one property, please complete a test form for each property you own.

If you are unsure as to the material, please submit a photo with this form.

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Your street address: *

Name: *

Telephone No: *

If you are unsure as to the material, please submit a photo here:

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png.

Were you able to complete test requested in the notice? *

What type of property is this?

Aproximately what year was your service line installed?

What size is your service line?

What is the color of the scraped pipe? (Silver, copper, brass, gray, black, or other)

Does a magnet stick to the pipe?

What is the material of the pipe? (Lead, copper, brass, galvanized steel, plastic, HDPE/pol or other)

Is there a water treatment system in the building? (Soft water system, filtration system, reverse osmosis system)

Do you know the materials of the water lines within your home? (Plastic, Copper, Other) *Optional*

Contact Information