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Water Service Line Questionnaire
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City Services
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Water
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Water Service Line Questionnaire
Name
(Required)
First
Last
Contact Number
(Required)
Account Number | Only the numbers left of the dash
(Required)
Service Address
(Required)
Meter
(Required)
What year was the house built?
Enter 4 digit year (Ex: 1950)
Have you replaced the water service line?
(Required)
Yes
No
If Yes, when?
(Required)
MM slash DD slash YYYY
If you have replaced the water service line, what pipe material was utilized (copper or plastic)?
Was the water service line replaced to the meter?
Yes
No
If you have not replaced the water service line, have you or a plumber excavated it for a repair?
Yes
No
When was the water service line excavated?
(Required)
MM slash DD slash YYYY
What pipe material was discovered with the water service line excavation (lead, galvanized/steel, copper or plastic)?
(Required)
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