Holden Customer Water Service Line Form

Holden 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
Please upload 1-3 photos of the scratched water service line. Examples are shown below.

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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?
If you are unable to determine the material type or cannot submit the inspection form, would you be interested in scheduling a basement inspection conducted by water system staff and/or their subcontractor to document the material type and size of your water service line?”
The Holden Water Department will have a limited number of appointments for home visits to determine the material of your service line for you. If you anticipate needing a site visit, then please submit this form to be added to the waitlist. A representative from the Town’s Engineering Consultant (Tighe & Bond) will contact you with additional details on how to schedule an inspection appointment.
Any additional comments or questions?
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Holden Water Service Line Form