Chester Customer Water Service Line Form

Chester Water Service Line Form

Submit your results
Full Name

First NameLast Name
Water Account Number
(If known)
Phone Number

Area CodePhone Number
Email Address
example@example.com
Address of Water Service

Street Address

Street Address Line 2

CityState

Zip Code
Does mailing address differ from Service Address
Mailing Address

Street Address

Street Address Line 2

CityState

Zip Code
How would you like to provide your water service material information?
Do you consent to having a basement inspection conducted by water system staff and/or their subcontractor to document the material type and size of your water service line?
Please select all of the dates/times that you would be available (at the water service address) to accompany Water System Staff or their subcontractor during an inspection of your water service line (select all that apply):

Morning: between 9:00am and 12:00pm

Afternoon: between 12:00pm and 4:00pm

A representative from the town's Engineering Consultant (Tighe & Bond) will follow up with the final date and time for your basement inspection.
Select all dates/times you are available (Please choose multiple)
Service Material
Service Diameter
Other Service Diameter
Date or year of water service install
(If known)
Do you have any point-of-entry or point-of use treatment on your cold-water kitchen or bathroom taps (softening, filter, or other treatment)?
Do your internal building plumbing materials include lead pipes or lead solder?
Please upload 1-3 photos of the scratched service line. Examples are shown above.

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Chester Water Service Line Form