Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Are You The
*
Owner
Tenant
Property Manager
Other
Building Type
*
Single Family
Multi Family
School / Childcare
Business
Other
What year were your water lines connected to the building, if known?
Please Select
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
What is the water line material where the water line enters your home?
*
Lead
Copper
Galvanized
Plastic - PVC
Plastic - PEX
Plastic - HDPE
Has your portion of the water line between the meter and home/building been replaced?
Yes
No
I don't know
If possible, upload a photo of the water line entering your home
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You can email a picture of the water line entering your home to pwsdclay3@gmail.com
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