Templeton Basement Inspection Booking Form

Basement Inspection Booking Form

Templeton Light and Water Department
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Water Account Number
(If known)
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
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?*

YesNo
Please select all of the dates/times that an adult 18 years or older 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 8:00am and 12:00pm

Afternoon: between 12:30pm and 2:30pm

Additional dates for inspections will be offered in March and April. Please select the box if you are interested in scheduling an inspection for one of these future dates.
Select all dates/times you are available (Please choose multiple)*

Wednesday, January 31 (Morning)Wednesday, January 31 (Afternoon)Thursday, February 1 (Morning)Thursday, February 1 (Afternoon)Monday, February 5 (Morning)Monday, February 5 (Afternoon)Tuesday, February 6 (Morning)Tuesday, February 6 (Afternoon)Select this box if you are interested in scheduling an inspection for a future date not listed above
Any Special Instructions
Should be Empty: