First Taxing District Water Department Water Service Line Form
Submit your results
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 Name
Last Name
Water Account Number
(If known)
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Address of Water Service
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Does Mailing Address differ from Service Address?
Yes
No
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
A representative from the FTDWD will contact you about scheduling your basement inspection.
Please include your general availability.
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Please include your appointment preferences below.
Please upload 1-3 photos of the scratched water service line. Examples are shown below.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Pipe Example
Service Material
*
Please Select
Copper
Lead
Galvanized
Unknown
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)?
Yes
No
Unknown
Do your internal building plumbing materials include lead pipes or lead solder?
Yes
No
Unknown
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