Customer Water Line Service Survey

Burton Water Cooperative Member:

We are required by the Washington Department of Health (WDOH) and the U.S. Environmental Protection Agency (EPA) to complete an inventory of the pipe material throughout our water system, both for the main distribution system (Co-op owned) as well as individual service lines (customer-owned). The intent of the inventory is to identify the prevalence of lead service lines (i.e., pipes made of lead material) throughout the system. This is a requirement for all water systems throughout the country – it’s not something we alone are being required to do. 

We have a good handle on the pipe material throughout the main distribution system. We have limited information on the approximately 415 customer-owned (i.e., your) service lines. We’re asking for your help to provide any information you may have regarding the pipe material of your individual service line. Your customer-owned service line runs from your meter (usually located near the road) to your house. Please complete this form with your knowledge of the material of your service line. See email for info on how to identify your service line material, or call (206)775-5667 with any questions.
Sign in to Google to save your progress. Learn more
Name of person responding *
Account number (4 digits, may begin with "0")
Service address *
To your knowledge, has the water service line for your building been replaced since 1986?
Clear selection
Service line material (from meter to building) *
Required
If "Non-lead other", what is your service line material?
How did you determine the material? Choose one. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report