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Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name
*
First Name
Last Name
Are you the owner of the residence?
Yes, I am the owner
No, I am a tenant
Phone Number
*
-
Area Code
Phone Number
Email
example@example.com
Service Material
*
Lead
Copper
Galvanized Steel
PVC
Service Size (Diameter of Pipe)
Unknown
1/2 inch
3/4 inch
1 inch
1.5 inch
2 inch
Please upload 1-3 photos of the scratched service line. Examples are shown.
*
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By submitting a photo, we can verify your pipe material and avoid the need for a future appointment. If you are having difficulty taking or uploading a photo, please email water@albanyny.gov
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example@example.com
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