Customer Service Line Survey
Name
First Name
Last Name
Account Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Signature
When was your home built?
Before 1988
After 1988
Unknown
What kind of property is it?
Single Family
Apartment/ Duplex
Commercial
My home has a...
Basement
Crawlspace
Slab
I am the property...
Owner
Tenant/ Renter
Manager
What is your water line material?
Lead
Galvanized Steel
Copper
PVC
Unknown
Other
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