Esopus Water Customer Service Line Form

Port Ewen Water District Water Service Line Form

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How would you like to provide your water service line information?

I will provide my service line information in this form.I would like the water department to inspect my water service in person.
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*

YesNo
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
A representative from Port Ewen Water District will contact you about scheduling your basement inspection.

If you have additional questions you can contact Nicholas Butler, Water & Sewer Superintendent, Email: Nbutler@esopus.com, Office: (845) 331-5900.

Please include your general availability or appointment preferences below and submit the form.
Please upload 1-3 photos of the scratched water service line. Examples are shown below.*

Browse Files

Cancelof
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)?

YesNoUnknown
Do your internal building plumbing materials include lead pipes or lead solder?

YesNoUnknown
Any additional comments or questions?
Should be Empty:

Port Ewen Water District Water Service Line Form